Autologous Retinal Transplantation for Primary and Refractory Macular Holes and Macular Hole Retinal Detachments

We aim to review scientific literature concerning published studies on autologous retinal transplantation to treat macular hole patients. The following databases were searched: Medline and Medline Non-Indexed Items, Embase (1990–2020), Ovid Medline® (1990 to November 2020), Embase (1990 to November 2020), Ovid Medline® and Epub Ahead of Print, in-Process and Web of Science (all years). Search keywords included “autologous”, “retinal transplant”, “autologous neurosensory retinal free flap” “transplantation”, “macular hole”, and “macular hole surgery”. Eighteen case series and single case reports were reviewed. Preoperative and final best-corrected visual acuity, microperimetry and multifocal electroretinogram findings, macular hole closure rate, preoperative and postoperative ellipsoid zone, and external limiting membrane defects were obtained and analyzed. Indications of autologous retinal transplantation for macular hole surgery included refractory macular holes, conventional techniques, and large macular holes. The number of cases included in the different case series ranged from 2 to 130 cases, and prior macular hole surgeries of the patients ranged from 0 to 3. Overall, the published case series of autologous retinal transplants have reported a macular hole closure rate of 66.7 to 100%, as well as a significant improvement in best-corrected visual acuity. The most frequently reported complications included considerable intraoperative bleeding and postoperative dislocation of the graft. The presence of functionality in the graft area has also been documented by microperimetry and multifocal electroretinogram. In conclusion, the autologous retinal transplantation technique for macular hole patients has emerged as another surgical option, with a high macular hole closure rate and visual improvement.

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Optical Coherence Tomography Findings in Idiopathic Macular Holes

Journal of Ophthalmology ◽

10.1155/2011/928205 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Lynn L. Huang ◽

David H. Levinson ◽

Jonathan P. Levine ◽

Umar Mian ◽

Irena Tsui

Keyword(s):

Optical Coherence Tomography ◽

Macular Hole ◽

Clinical Assessment ◽

Chart Review ◽

Subretinal Fluid ◽

Optical Coherence ◽

Cross Sectional ◽

Macular Holes ◽

Idiopathic Macular Holes ◽

Intraretinal Cysts

Purpose. To describe the characteristics of idiopathic macular holes (MH) on optical coherence tomography (OCT) and correlate OCT with clinical assessment.Design. Cross-sectional chart review and OCT assessment.Participants. Sixty-seven eyes with a clinically diagnosed idiopathic MH with available OCT data.Methods. A retrospective chart review and OCT assessment.Results. Based on OCT grading, 40 eyes had a full-thickness macular hole (FTMH) and 21 eyes had a lamellar macular hole (LMH). Clinical exam and OCT assessment agreed in 53 (87%) eyes when assessing the extent of MH. Six eyes (14.6%) in the FTMH group, and 3 eyes in the LMH group (14.3%) had persistent vitreomacular traction. Thirty-seven eyes (92.5%) in the FTMH group and 11 eyes (52.4%) in the LMH group had associated intraretinal cysts. Two eyes (5.0%) in the FTMH group and zero eyes in the LMH group had subretinal fluid. Intraretinal cysts were found to be more frequently associated with FTMH than with LMH (P<0.001).Conclusion. This paper described OCT findings in a group of patients with clinically diagnosed MH. A high level of correlation between clinical assessment and OCT findings of LMH and FTMH was observed, and intraretinal cysts were often present in FTMH.

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Autologous Lens Capsule Flap Transplantation for Persistent Macular Holes

Journal of Ophthalmology ◽

10.1155/2021/8148792 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Sławomir Cisiecki ◽

Karolina Bonińska ◽

Maciej Bednarski

Keyword(s):

Macular Hole ◽

Functional Outcomes ◽

Lens Capsule ◽

Operative Techniques ◽

Basal Diameter ◽

Macular Holes ◽

Capsular Flap ◽

Potential Alternative ◽

The Mean ◽

Hole Closure

Purpose. To analyze the anatomical and functional outcomes after autologous lens capsule transplantation in patients with persistent macular hole. Methods. This is a retrospective observational study of five eyes of five patients treated with vitrectomy and autologous lens capsular flap transplantation. Complete ophthalmic examination was performed preoperatively and seven days and 1, 3, 6, 12, and 18 months after surgery. Results. Successful macular hole closure was achieved in all patients. The mean minimum macular hole diameter before the surgery was 666.8 µm, and the mean basal diameter was 1086.4 µm. The mean visual acuity before lens capsular flap transplantation was 20/200, while after surgery, it was 20/125. Conclusions. Autologous lens capsular flap transplantation is a potential alternative treatment for patients with large persistent macular holes after other operative techniques have failed.

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Morphofunctional analysis of the retina in the surgical treatment of idiopathic macular holes

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-48-52 ◽

2021 ◽

pp. 48-52

Author(s):

A.S. Zotov ◽

◽

A.S. Balalin ◽

S.V. Balalin ◽

S.M. Purshak ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Surgical Treatment ◽

Macular Hole ◽

Practical Importance ◽

Functional Results ◽

Hole Diameter ◽

Optical Coherence ◽

Macular Holes ◽

Idiopathic Macular Holes ◽

Morphofunctional Analysis

Purpose. To evaluate the role of microperimetry and optical coherence tomography (OCT) in the morphofunctional analysis of the retina after surgical treatment of idiopathic macular holes (IMH). Materials and methods. A retrospective study of 33 patient's treatment results (33 eyes) with IMH was carried out. All patients underwent minimally invasive with 25G or 27G vitrectomy. Best corrected visual acuity (BCVA), macular photosensitivity, fixation stability, macular neuroepithelial (NE) volume and minimal macular hole diameter were analyzed. Follow-up period: 6 months. Results. A complete closure of the macular hole was achieved in all cases post-op. The patients had reliable improvement of BCVA, retinal photosensitivity and decrease of macular NE volume. Based on a multifactor correlation analysis with the purpose to predict the results of surgical treatment, the dependence of post-op BCVA on the pre-op photosensitivity of the retina and the minimal diameter of the macular hole was revealed. Conclusions. Microperimetry and OCT are modern non-invasive research methods allowing to estimate anatomical and functional results of surgical IMH treatment. The study of retinal photosensitivity in the macula and minimal macular hole diameter pre-op allows to predict post-op BCVA, which has a practical importance. Keywords: idiopathic macular hole, vitrectomy, microperimetry, optical coherence tomography.

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A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

Case Reports in Ophthalmological Medicine ◽

10.1155/2020/8824995 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

A. Altun

Keyword(s):

Visual Acuity ◽

Macular Hole ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Surgical Experience ◽

Flap Technique ◽

Macular Holes ◽

Female Case ◽

Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

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An Internal Limiting Membrane Plug and Gas Endotamponade for Recurrent or Persistent Macular Hole

Journal of Ophthalmology ◽

10.1155/2019/6051724 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Fabrizio Giansanti ◽

Ruggero Tartaro ◽

Tomaso Caporossi ◽

Daniela Bacherini ◽

Alfonso Savastano ◽

...

Keyword(s):

Macular Hole ◽

Case Series ◽

Internal Limiting Membrane ◽

Swept Source ◽

Macular Holes ◽

Small Gauge ◽

Pars Plana ◽

The Mean ◽

23 Gauge ◽

Anatomical Success

Introduction. Recurrent or persistent macular holes (MHs) are rare today due to the tendency to carefully peel the internal limiting membrane. Conversely, their treatment is still a challenge for a vitreoretinal surgeon. Materials and Methods. This is a retrospective, consecutive, and nonrandomized study of patients affected by recurrent or persistent MHs treated using small-gauge pars plana vitrectomy (25- or 23-gauge) and an autologous ILM plug, at the Eye Clinic of Azienda Ospedaliera Universitaria Careggi (Florence, Italy) between January 2016 and May 2018. We included 8 eyes of 8 patients in the study. Five patients had a recurrent MH while 3 had a persistent MH. The case series includes patients with myopic eyes and with large macular holes (>400 μ). Patients were followed up with ophthalmoscopic examinations and swept-source optical coherence tomography (SS-OCT). Results. The mean age of the patients was 74 years (±4.81 standard deviation (SD)), 3 patients were men and 5 women. The average axial length was 26.28 mm (±2.84 SD). Four patients had an AL ≧ 26 mm. The mean MH diameter was 436.5 (±49.82 SD). Average preoperative best-corrected visual acuity (BCVA) was 0.81 logMAR (±0.16 SD) and 20/125 Snellen. The ILM plug has been found integrated in the MH in all the follow-ups. Conclusion. In our study, an ILM autologous macular transplant was used successfully in 5 cases of macular hole recurrence and 3 cases of macular hole persistence. The anatomical success was achieved in all the cases; 4 patients improved their BCVA, and 4 patients maintained it. No macular alterations such as RPE or retinal atrophy/dystrophy were observed after 6 months.

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Sulfur Hexafluoride (SF6) versus Perfluoropropane (C3F8) in the Intraoperative Management of Macular Holes: A Systematic Review and Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2019/1820850 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Idan Hecht ◽

Michael Mimouni ◽

Eytan Z. Blumenthal ◽

Yoreh Barak

Keyword(s):

Adverse Events ◽

Confidence Interval ◽

Macular Hole ◽

Primary Closure ◽

Meta Analysis ◽

Macular Hole Surgery ◽

Visual Outcomes ◽

Macular Holes ◽

Increased Risk ◽

Intraoperative Management

Purpose. A systematic literature search was conducted to identify and review studies comparing SF6 to C3F8 as a tamponade agent in the intraoperative management of macular holes. Methods. Publications up to October 2018 that focused on macular hole surgery in terms of primary closure, complications, and clinical outcomes were included. Forest plots were created using a weighted summary of proportion meta-analysis. Analysis was performed separately for SF6 and C3F8. A random effects model was used, and corresponding I2 heterogeneity estimates were calculated. Results. Nine pertinent publications studying a total of 4,715 patients were identified in 2000 to 2017, including two randomized studies (n=206), two prospective studies (n=170), and five retrospective or registry-based studies. Similar rates of closure between SF6 and C3F8 were reported in eight out of nine studies, regardless of subgroup analyses. All studies reporting visual outcomes showed similar results when comparing SF6 to C3F8 at one to six months of follow-up. Neither agent was clearly associated with increased risk of ocular hypertension, cataract formation, or other adverse events. Meta-analytic pooling of the closure rates in the SF6 group resulted in 91.73% (95% confidence interval: 88.40 to 94.55, I2: 38.03%), and for C3F8, the closure rate was 88.36% (95% confidence interval: 85.88 to 90.63, I2: 0.0%). Conclusions. Both SF6 and C3F8 appear to have achieved similar visual outcomes and primary closure rates and neither was associated with an increased risk of adverse events. Considering the more rapid visual recovery with SF6, there appears to be no evidence to support C3F8 as the tamponade agent of choice for macular hole surgery.

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Autologous neurosensory retinal transplantation for recurrent macular hole retinal detachment in highly myopic eyes

Acta Ophthalmologica ◽

10.1111/aos.14442 ◽

2020 ◽

Vol 98 (8) ◽

Author(s):

Yanzi Li ◽

Zhaohui Li ◽

Changzhong Xu ◽

Yong Liu ◽

Xueqin Kang ◽

...

Keyword(s):

Retinal Detachment ◽

Macular Hole ◽

Retinal Transplantation ◽

Macular Hole Retinal Detachment

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AUTOLOGOUS RETINAL TRANSPLANTATION AS A PRIMARY TREATMENT FOR LARGE CHRONIC MACULAR HOLES

Retina ◽

10.1097/iae.0000000000002693 ◽

2019 ◽

Vol Publish Ahead of Print ◽

Cited By ~ 4

Author(s):

Shin Tanaka ◽

Maiko Inoue ◽

Tatsuya Inoue ◽

Tadashi Yamakawa ◽

Eiichi Uchio ◽

...

Keyword(s):

Primary Treatment ◽

Retinal Transplantation ◽

Macular Holes

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Characteristics and Risk Factors for Spontaneous Closure of Idiopathic Full-Thickness Macular Hole

Journal of Ophthalmology ◽

10.1155/2019/4793764 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Xida Liang ◽

Wu Liu

Keyword(s):

Risk Factors ◽

Macular Hole ◽

Case Reports ◽

Primary Treatment ◽

Small Sample ◽

Spontaneous Closure ◽

Full Thickness ◽

Macular Holes ◽

Pubmed Database ◽

Full Thickness Macular Hole

Idiopathic full-thickness macular hole is a severe visual impairment disease. Pars plana vitrectomy remains the primary treatment option for idiopathic full-thickness macular holes, and over 90% idiopathic full-thickness macular holes are closed by vitrectomy surgery. However, the full-thickness macular hole may close spontaneously, with a good visual acuity progress. Since recent studies are small-sample studies and case reports, the characteristics for spontaneous closure of idiopathic full-thickness macular holes are not fully understood. Here, we review the articles in PubMed database from 1999 to 2018 and discuss the characteristic and the risk factors, especially OCT structure features, for spontaneous closure of idiopathic full-thickness macular holes.

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