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Best-corrected visual acuity (BCVA, Snellen), optical coherence tomography and fundus photography were scheduled at baseline and every follow-up visit (1, 3, 6, 12, 18, 24 months and the most recent). Preoperatively, we collected minimum linear diameter (MLD) and basal diameter (BD). Post-operatively, rates of external limiting membrane (ELM)\/ellipsoid zone (EZ) restoration, excessive gliosis and subfoveal retinal pigmented epithelium (RPE) atrophy were evaluated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Average AXL was 31.45\u2009\u00b1\u20092.07\u00a0mm and mean follow-up was 47.2\u2009\u00b1\u200931.4 months. Anatomical success was reached in 7\/13 eyes (54%), while 2 cases showed persisting HMMH, 2 cases had early recurrence and 2 cases late recurrence. BCVA went from 0.19\u2009\u00b1\u20090.18 to 0.22\u2009\u00b1\u20090.20 at final follow-up (<jats:italic>p<\/jats:italic>\u2009=\u20090.64), improving in 5\/13 eyes (38%). One eye showed continuous ELM and EZ lines, while another eye showed an irregular ELM but no EZ. Post-operatively, 5 eyes (71%) developed progressive atrophy of the subfoveal RPE, while excessive gliosis was reported in 3 eyes (43%). Furthermore, one patient developed post-operative chronic macular edema-like changes in the perifoveal area.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Autologous ILM transplantation showed controversial anatomical outcomes and and poor visual results in refractory HMMH. Moreover, progressive subfoveal patchy atrophy and excessive gliosis are possible post-operative complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00417-024-06533-7","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T11:45:28Z","timestamp":1717501528000},"page":"3531-3541","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Shortfalls of free autologous internal limiting membrane transplantation for highly myopic refractory macular holes in a long term follow-up"],"prefix":"10.1007","volume":"262","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2979-1638","authenticated-orcid":false,"given":"Matteo Mario","family":"Carl\u00e0","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Mateo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"6533_CR1","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1016\/j.ophtha.2009.11.003","volume":"117","author":"K Hayashi","year":"2010","unstructured":"Hayashi K, Ohno-Matsui K, Shimada N, Moriyama M, Kojima A, Hayashi W, Yasuzumi K, Nagaoka N, Saka N, Yoshida T, Tokoro T, Mochizuki M (2010) Long-term pattern of progression of myopic maculopathy: a natural history study. 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