Successful Treatment of Two Cases of Refractory Macular Holes With Intentional Retinal Detachment and Posterior Capsule Transplantation

We present two cases of refractory macular holes that were successfully treated with intentional retinal detachment and posterior lens capsule transplantation. Case 1 involves a 60-year-old man with a three-year history of vision loss, who was diagnosed with macular holes in both eyes. Initial treatments, including vitrectomy and internal limiting membrane translocation in the right eye, led to hole closure, but the left eye required reoperation. In the second surgery, the left eye underwent intentional retinal detachment combined with posterior capsule transplantation and tamponade with 9% octafluoropropane. This resulted in the successful closure of the macular hole and improved visual acuity. Case 2 involves a 69-year-old woman who was previously operated on for a macular hole and was referred for reoperation. Optical coherence tomography revealed a 622 μm macular hole in her left eye. Following discussions on the risk, intentional retinal detachment and posterior capsule transplantation were performed. Postoperative optical coherence tomography confirmed the closure of the macular hole and improvement in symptoms. The combination of intentional retinal detachment and posterior capsule transplantation is helpful and a novel technique for refractory macular holes that do not close after initial surgery.