scholarly journals Autologous Lens Capsule Flap Transplantation for Persistent Macular Holes

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.

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

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
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.

scholarly journals Newer indices for predicting macular hole closure in idiopathic macular holes: A retrospective, comparative study

2019 ◽  
Vol 67 (11) ◽  
pp. 1857 ◽  
Author(s):  
Ramesh Venkatesh ◽  
Ashwin Mohan ◽  
Shivani Sinha ◽  
Aditya Aseem ◽  
NareshKumar Yadav
Keyword(s):  
Comparative Study ◽  
Macular Hole ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Retrospective Comparative Study ◽  
Hole Closure

scholarly journals The outcome of vitrectomy with internal limiting membrane peeling for chronic macular hole at Biratnagar eye hospital: A tertiary eye care center in Nepal

2016 ◽  
Vol 7 (6) ◽  
pp. 43-46
Author(s):  
Lalit Agarwal ◽  
Nisha Agrawal ◽  
Pratap Karki ◽  
Abhishek Anand
Keyword(s):  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Chronic Stage ◽  
Visual Improvement ◽  
Macular Holes ◽  
Pars Plana ◽  
Hole Closure

Background:  A macular hole is a full-thickness defect of retinal tissue involving the anatomic fovea, thereby affecting central visual acuity. Pars plana vitrectomy and gas tamponade is a recognised modality of treatment for macular hole.Larger holes are more likely to remain open after repair and late reopening after an initially closed macular hole is seen in macular holes larger than 400 μm.Aims and Objective: To evaluate the anatomical and functional outcome of pars plana vitrectomy with internal limiting membrane peeling for chronic stage 3 macular hole.Materials and Methods: Records of 15 patients with stage 3 chronic macular holes operated from 1st January 2013 to 30th June 2013 and completed 1 year of follow up were retrospectively evaluated and included in the study. Preoperative best distance corrected visual acuity (BCVA), preoperative macular hole size, final BCVA and macular hole status at 1 year follow up were recorded. Macular hole closure and visual improvement was calculated. Correlation of macular hole closure and visual improvement with various macular hole parameter was estimated.Results: Eleven (73.3%) macular holes closed at 1 year follow-up. Mean BCVA improved from 1.2 ± 0.27 to 0.89 ± 0.36 logarithm of minimum angle of resolution at 1 year (p<0.001). Visual improvement was seen in only eight (53.3%) eyes. Both macular hole closure and visual improvement showed no correlation with minimum linear diameter, base diameter and hole height.Conclusion: Chronic stage 3 macular hole can be closed successfully in majority of patients with fairly good visual improvement. Macular hole parameters of stage 3 holes may not have any correlation with the anatomical and visual outcome.Asian Journal of Medical Sciences Vol.7(6) 2016 43-46

Air vs Gas Tamponade During Macular Hole Repair Surgery

2020 ◽  
Vol 4 (5) ◽  
pp. 360-363
Author(s):  
Shriji N. Patel ◽  
Janice Law ◽  
Edward Cherney ◽  
Franco Recchia ◽  
Stephen J. Kim
Keyword(s):  
Macular Hole ◽  
Sulfur Hexafluoride ◽  
Final Analysis ◽  
Gas Tamponade ◽  
Macular Holes ◽  
Full Thickness Macular Hole ◽  
Significant Difference ◽  
Pars Plana ◽  
Operative Report ◽  
Hole Closure

Purpose: This work investigates the visual and anatomical outcomes of full-thickness macular hole (FTMH) repair surgery using air in comparison to gas tamponade. Methods: A retrospective consecutive review of medical records was undertaken of all patients undergoing pars plana vitrectomy for idiopathic FTMH at an academic practice from January 2010 to May 2017. Each operative report was reviewed to investigate the agent used for tamponade at the end of the surgery. Preoperative hole duration and size as measured using optical coherence tomography as well as successful postoperative hole closure were recorded. Use of gas or air was not randomized and was instilled at surgeon discretion. Results: The final analysis included 211 eyes. Gas was used as the tamponade agent in 171 of the 211 eyes; most of these eyes (144 of 171) received sulfur hexafluoride (SF6) and the remainder received perfluoropropane (C3F8). Forty eyes underwent only a complete fluid-air exchange without any gas placement following vitrectomy. There was no statistically significant difference between the 2 groups in mean preoperative macular hole size ( P = .43). Nine of the 171 macular holes receiving gas tamponade failed to close (5.3%). One of the 40 macular holes receiving only air failed to close (2.5%). There was no statistically significant difference in hole closure rates between the 2 groups ( P = .45). Conclusions: Air served as an equally efficacious internal tamponade agent in comparison to nonexpansile gas following idiopathic FTMH repair surgery.

scholarly journals Autologous Retinal Transplant for Macular Hole

2021 ◽  
Vol 15 (1) ◽  
pp. 292-298
Author(s):  
Sergio E. Hernández Da Mota ◽  
Virgilio Morales-Cantón ◽  
Sergio Rojas-Juárez ◽  
Antonio López-Bolaños ◽  
Abel Ramírez-Estudillo ◽  
...  
Keyword(s):  
Macular Hole ◽  
Multifocal Electroretinogram ◽  
Case Series ◽  
Macular Hole Surgery ◽  
Closure Rate ◽  
Retinal Transplantation ◽  
Ovid Medline ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Hole Closure

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.

Spontaneous Macular Hole Closure in Bilateral Macular Holes

2007 ◽  
Vol 22 (3) ◽  
pp. 167-169 ◽  
Author(s):  
Peter H. Win ◽  
Tara A. Young
Keyword(s):  
Macular Hole ◽  
Macular Holes ◽  
Hole Closure

scholarly journals A short term anatomical and visual outcomes of large idiopathic macular holes surgery following inverted internal limiting membrane flap technique

2019 ◽  
Vol 11 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Kiran Shakya ◽  
Ram Prasad Pokharel ◽  
Om Krishna Malla
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Hole Filling ◽  
Flap Technique ◽  
Macular Holes ◽  
Snellen Chart ◽  
Pars Plana ◽  
Idiopathic Macular Holes ◽  
The Mean

Introduction: Large macular holes are not uncommon among Nepalese women population causing severe visual problem. Objective: To evaluate the technique of inverted internal limiting membrane (ILM) flaps for the repairment of large macular holes. Methods: All 10 macular holes (diameter > 400 μm) were treated with pars planavitrectomy with inverted ILM flap technique. The procedure for macular hole surgerywas pars plana vitrectomy, posterior vitreous removal, internal limiting membrane(ILM) peeling with brilliant blue assisted, inverting ILM flap into macular hole, filling of the vitreous cavity with a gas bubble(C3 F8) and post-operative face-down positioning for 1 week. SD OCT images were taken preoperative and postoperative 1 month and 3 months follow up to assess the anatomical outcome of surgery and best corrected visual acuity (BCVA) was used to evaluate the functional outcome during each visit. The BCVA was recorded using the Snellen chart and was converted to the logarithm of the minimum angle of resolution (LogMAR) equivalents. Results: All 10 eyes had complete anatomical closure. The mean age of patients was 64.3 ± 7.53 years. The mean macular hole base diameter was 1039.4 μm (663-1526μm). Mean BVCA pre-operatively was 1.29 log MAR ±SD 0.25. Post-operatively, mean BCVA was 0.925 log MAR ±SD 0.143 (p= 0.002). There were no intra operative or post-operative complications. All the patients were followed up for a period of 3months. Conclusions: Inverted ILM flaps is effective for closure of the large macular hole and restoration of functional vision.

scholarly journals Visual Field Loss Progression after Macular Hole Surgery

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Gian Marco Tosi ◽  
Gianluca Martone ◽  
Angelo Balestrazzi ◽  
Alex Malandrini ◽  
Marco Alegente ◽  
...  
Keyword(s):  
Visual Field ◽  
Macular Hole ◽  
Visual Field Loss ◽  
Field Testing ◽  
Visual Field Defects ◽  
Macular Hole Surgery ◽  
Macular Holes ◽  
Blind Area ◽  
History Of ◽  
Hole Closure

Purpose. To report a patient who experienced visual field loss progression after vitrectomy for an idiopathic stage II macular hole.Methods. Case report. A 68-year-old woman, with no history of glaucoma or any neuroophthalmological diseases, underwent a vitrectomy for a macular hole.Results. The patient showed macular hole closure and a resulting central visual acuity of 20/20. However, two months after surgery, she developed an inferotemporal visual field defect. Moreover, seven months after surgery, the patient noticed an enlargement of the temporal blind area: a nearly complete temporal defect was confirmed on visual field testing.Conclusions. Although the beneficial results of successfully treated macular holes are unquestionable, this report raises the possibility that visual field defects following macular hole surgery may be progressive.

scholarly journals Efficacy of inverted internal limiting membrane flap for large idiopathic macular holes

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Haroon Tayyab ◽  
Asad Aslam Khan ◽  
Sana Jahangir
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Creative Commons ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Best Corrected Visual Acuity ◽  
Hole Closure ◽  
Sd Oct

Objective: To evaluate the effectiveness of inverted internal limiting membrane flap in large idiopathic macular holes. Methods: Twelve patients diagnosed with idiopathic macular holes larger than 400um underwent 23 gauge Pars Plana Vitrectomy (PPV) with inverted internal limiting flap and gas tamponade at Al-Ehsan Eye Welfare Eye Hospital, Lahore from February 2017 to February 2018. All cases were diagnosed on Spectral Domain Optical Coherence Tomography (SD-OCT) and were followed up for 6 months. At every follow-up, best corrected visual acuity and SD-OCT was done. Results: We achieved macular hole closure in 91.6% (11/12) patients with idiopathic macular holes larger than 400um. Five out of 12 patients underwent combined phacoemulsification and PPV. One patient has flat hole closure which was considered failure. One patient was excluded from the study due to per-operative flap loss. This patient was not included in final data analysis of 12 patients. There was statistically significant gain in best corrected visual acuity after successful macular hole closure. We did not report any untoward events during or in the post-operative period. Conclusion: Inverted internal limiting flap is an effective method for repairing large macular holes. How to cite this:Tayyab H, Khan AA, Jahangir S. Efficacy of inverted internal limiting membrane flap for large idiopathic macular holes. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.689 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Krypton yellow laser for the treatment of macular hole in high myopia without retinal detachment

2008 ◽  
Vol 31 (6) ◽  
pp. 357
Author(s):  
Ji-Ping Cai ◽  
Jin-Wei Cheng ◽  
Xiao-Ye Ma ◽  
Yu-Zhen Li ◽  
You Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Vitamin B1 ◽  
Macular Holes ◽  
Yellow Laser ◽  
Group A ◽  
The Mean ◽  
Group B

Purpose To evaluate the prophylactic effect of krypton yellow laser for the treatment of macular holes in high myopic eyes in order to reduce the risk of retinal detachment. Methods Twenty-seven eyes of 27 patients with high myopia and macular holes were randomly assigned to two groups. Fifteen patients (group A, 15 eyes) were subject to laser photocoagulation around the hole margin along with an oral placebo (vitamin B1), while 12 patients (group B, 12 eyes) were only given the oral placebo (vitamin B1). The incident rate of retinal detachment due to macular hole and the mean best-corrected visual acuity of the two groups before and after treatment were measured. The data were statistically tested by X2 test and Student’s t test. Results The incident rates of retina1 detachment in group A and group B were 20%(3/15) and 58.3%(7/12), respectively (X2=4.201, P0.05). The mean BCVA of group B on the initial examination was 24/200, while the mean BCVA at the final follow-up was 30/200 (P>0.05). No significant difference in initial visual acuity (P>0.05) or final visual acuity (P>0.05) was found between the two groups. Conclusion Krypton yellow laser photocoagulation could reduce the incidence of retinal detachment due to a macular hole in high myopia with acceptable functional results in this study.

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