Purpose: To describe a simple, reproducible marking technique to confirm correct epithelial orientation of human amniotic membrane (hAM) during subretinal implantation in complex vitreoretinal surgery for massive subretinal hemorrhage. Methods: A single-surgeon case report of a patient with massive subretinal hemorrhage managed by 23-gauge pars plana vitrectomy, retinal turnover, and subretinal hAM implantation. Prior to intraocular insertion, an “F” letter mark was applied to the epithelial surface of the graft using gentian violet dye, enabling unambiguous identification of membrane orientation throughout folding and intraocular delivery. Results: The gentian violet “F” mark remained clearly visible at each surgical step — forceps insertion and subretinal placement — enabling immediate confirmation of graft orientation and correct apposition of the stromal surface against the retinal pigment epithelium. No intraoperative complications related to the dye were observed. Postoperative optical coherence tomography (OCT) confirmed anatomically correct graft positioning, stable retinal reattachment, and progressive improvement in best-corrected visual acuity (BCVA). Conclusion: Gentian violet “F” marking of the hAM epithelial surface is a straightforward, safe, and reproducible adjunct for orientation verification in complex vitreoretinal surgery, where tissue transparency and repeated intraocular manipulation pose a significant risk of incorrect graft placement.

Purpose: To evaluate the anatomical and functional outcomes of an epiretinal cryopreserved human amniotic membrane (hAM) overlay technique for the management of recurrent retinal detachment (RD) associated with peripapillary breaks in highly myopic eyes. Methods: Retrospective interventional case series including five eyes with recurrent RD (mean axial length 30.70 ± 2.03 mm). Two eyes presented with recurrence under silicone oil (SO) tamponade, and three after prior SO removal. All eyes underwent 25-gauge pars plana vitrectomy with SO removal when present. A customized 8–9 mm hAM patch was positioned epiretinally and unrolled bimanually under perfluorocarbon liquid (PFCL). Final tamponade was achieved with SO 1000 cSt, followed by scheduled SO removal. Results: Complete retinal reattachment was achieved in all cases (100%) after a single procedure and remained stable throughout follow-up. Mean best-corrected visual acuity (BCVA) improved from 1.00 ± 0.60 to 0.68 ± 0.58 logMAR at 2 months after SO removal (p = 0.068). Optical coherence tomography demonstrated stable integration of the hAM as a hyperreflective layer over the peripapillary defects. No cases of graft dislocation, proliferative vitreoretinopathy, or significant inflammatory complications were observed. Conclusions: The epiretinal hAM overlay technique appears to be a safe and effective approach for sealing complex peripapillary breaks in highly myopic eyes with chorioretinal atrophy. By providing both mechanical support and a biological scaffold for tissue repair, this technique may represent a valuable surgical option in cases where conventional retinopexy is not feasible or has failed.