{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T21:32:40Z","timestamp":1782768760344,"version":"3.54.5"},"reference-count":26,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objective: In recent years, the success rate of treating refractory macular holes with internal limiting membrane (ILM) inversion has significantly increased. However, closure remains challenging for large macular holes even after ILM inversion. Here, we report the evaluation of amniotic membrane coverage for intractable large macular holes. Methods: We retrospectively analyzed five eyes of five patients (three males, two females; mean age 70.6 \u00b1 13.3 years) with refractory macular holes that did not close after ILM inversion performed at our institution from June 2022 to May 2024 and were followed up for more than 6 months. Preoperative macular hole dimensions were assessed using optical coherence tomography (OCT). Surgery was performed using 27-gauge transconjunctival vitrectomy without ILM peeling. Two layers of amniotic membrane were placed in the macular center using a double-headed technique under air tamponade, followed by a complete vitreous fluid exchange with 10% sulfur hexafluoride gas. Postoperative outcomes were evaluated using OCT for macular hole closure and visual function assessment 6 months postoperatively. Results: The preoperative macular hole size was 1072.200 \u00b1 189.043 \u03bcm, and the preoperative logMAR visual acuity was 1.222 \u00b1 0.278. All macular holes closed postoperatively, with a postoperative logMAR visual acuity of 0.518 \u00b1 0.165. Conclusions: The amniotic membrane coverage technique for intractable large macular holes was found to be an effective method contributing to macular hole closure and visual acuity improvement postoperatively.<\/jats:p>","DOI":"10.3390\/jcm14113708","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T02:50:05Z","timestamp":1748227805000},"page":"3708","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Amniotic Membrane Coverage for Intractable Large Macular Holes: A First Report with Japanese Patients"],"prefix":"10.3390","volume":"14","author":[{"given":"Yasunari","family":"Hayakawa","sequence":"first","affiliation":[{"name":"Urawa Central Eye Institution, Saitama 336-0042, Japan"},{"name":"Kumagaya Central Eye Institution, Kumagaya 360-0833, Japan"},{"name":"Yorii Central Eye Institution, Yorii 369-1202, Japan"},{"name":"Kisarazu Central Eye Institution, Kisarazu 292-0823, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Inada","sequence":"additional","affiliation":[{"name":"Urawa Central Eye Institution, Saitama 336-0042, Japan"},{"name":"Kumagaya Central Eye Institution, Kumagaya 360-0833, Japan"},{"name":"Yorii Central Eye Institution, Yorii 369-1202, Japan"},{"name":"Kisarazu Central Eye Institution, Kisarazu 292-0823, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2003001","DOI":"10.1155\/2021\/2003001","article-title":"Internal Limiting Membrane Peeling and Flap Inverting under Air in Large Idiopathic Macular Hole Surgery","volume":"2021","author":"Zong","year":"2021","journal-title":"J. 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