Purpose: To demonstrate immediate closure of macular holes (MHs) with internal limiting membrane (ILM) plug placement and heavy silicone oil (SO) tamponade after pars plana vitrectomy (PPV). Method: A retrospective review was performed of 14 eyes undergoing MH repair with 23-gauge PPV, ILM plug placement, and heavy SO (Densiron Xtra) tamponade. Clinical examination findings, optical coherence tomography (OCT)-confirmed MH closure, and visual acuity (VA) outcomes were evaluated with a follow-up of at least 6 months. Results: Complete MH closure was achieved in all eyes within 24 hours, with total resolution of cysts. No postoperative macular edema or bridging fibrosis was observed. Mean VA improved from 0.25 preoperatively to 0.5 at the final follow-up. Anatomic closure was consistent across all MH subtypes. Conclusions: The ILM plug technique combined with heavy SO tamponade resulted in 100% early MH closure within 24 hours postoperatively, with excellent anatomic improvement and stability, in addition to significant improvement in VA. This approach may represent a viable surgical option in selected complex MH cases.
Riotto et al. (2026) studied this question.