Amniotic membrane and inverted internal limiting membrane grafts assisted by the sub-perfluorocarbon viscoat injection technique for optic disc pit maculopathy: A case series

Abstract: Three eyes with optic disc pit (ODP) maculopathy underwent vitrectomy, insertion of a human amniotic membrane graft (hAMG) into the pit, and application of an inverted internal limiting membrane (ILM) graft covering the pit opening. The surgery was assisted by the sub-perfluorocarbon liquid ophthalmic viscoelastic device injection technique (SPOT) and intraoperative optical coherence tomography. Intraoperatively, the hAMG and the ILM flap were easy to manipulate using the SPOT technique. At 3 months after surgery, the hAMG was plugging the pit, and the inverted ILM covering was covering the top of the optic disc head. Subretinal fluid and intraretinal schisis both decreased. In two eyes, vision improved from 20/100 to 20/30 at 6 months and from 20/1000 to 20/60 at 8 months, respectively. The third eye’s vision remained at counting fingers, likely due to baseline disciform scarring. In summary, the tamponade of the ODP with hAMG and covering the pit opening with inverted ILM graft created a robust barrier and swiftly resolved the macular fluid in ODP maculopathy. SPOT facilitated the manipulation of the graft and provided intraoperative and postoperative stability to the grafts, but one needs to be aware that the perfluorocarbon might migrate into the pit.