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 ◽  
...  

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.

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Kinza T. Ahmad ◽  
Joseph Chacko ◽  
Ahmed B. Sallam ◽  
David B. Warner ◽  
Sami H. Uwaydat

Introduction. The few published studies that exist on the surgical outcomes of full-thickness macular hole (FTMH) repair in Macular Telangiectasia (MacTel) Type 2 report poor rates of hole closure of around 30%. This study is the largest case series of patients with FTMH in MacTel Type 2 and describes an 80% hole closure rate. Purpose/Aim. To describe the outcomes of four patients who underwent surgery for FTMH associated with MacTel Type 2. Methods. A retrospective review of clinical, surgical, and imaging data of five eyes in four patients with MacTel Type 2 FTMH who underwent pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and 30% SF6 or 15% C3F8 gas tamponade within 3-9 months of initial vision decline. Results. Visual acuity (VA) at the time of surgery ranged from 20/50 to 20/200. Successful hole closure was achieved in four out of five eyes, and final VA ranged from 20/20 to 20/40 at follow-up visits greater than 20 months postoperatively. The single eye that did not achieve hole closure had a final VA of 20/60. Conclusion. Our case series describes higher hole closure rates and better final VA than previously published reports for macular hole surgery in patients with MacTel Type 2 FTMH.


2022 ◽  
Vol 14 ◽  
pp. 251584142110632
Author(s):  
Shaheryar Ahmed Khan ◽  
Craig Goldsmith ◽  
Mya Thandar So

Macular hole surgery has been revolutionized since the 1990s’ with the advent of pars plana vitrectomy with internal limiting membrane peeling and gas tamponade, which is now extensively practiced and regarded as the gold standard procedure for surgical treatment of macular hole. Here, we report a simple adjunctive maneuver to conventional PPV with ILM peel and gas tamponade. We observed presence of a viscous fluid in the base of the macular hole in our series. In all, 40 eyes of 39 patients consecutively operated on from June 2019 to December 2020 for PPV with ILM peel and gas tamponade, were included in this study. The viscous plug was aspirated passively using a 25 gauge cannula with its tip above the macular hole, approaching only until a fluid-wave was visualized, which resulted in flattening of the fluid cuff area aiding the macular hole closure in a concentric pattern. Macular hole closure and complete success was seen in 39 out of 40 eyes (97.5%) and only 1 failure (2.5%) observed in this series. In our case series, we have observed the presence of a viscous fluid plug in the macular hole. We demonstrated that aspirating this thick fluid from the hole results in the flattening of the cuff of fluid and subsequent closure of the macular hole in a concentric manner in almost all cases in our series. The lack of concurrent control group means we cannot state a definitive effect of the intervention, but it does suggest the utility of a prospective randomized controlled trial.


2019 ◽  
Vol 4 (1) ◽  
pp. 22-27
Author(s):  
Nikisha Kothari ◽  
Sarah P. Read ◽  
Caroline R. Baumal ◽  
Antonio Capone ◽  
Emmanuel Chang ◽  
...  

Purpose: Pediatric macular holes occur often related to trauma and rarely require surgical intervention. The purpose of the present study was to evaluate outcomes of microincisional vitrectomy surgery. Methods: A multicenter retrospective consecutive case series was conducted of pediatric patients undergoing surgery for macular hole repair. Results: A total of 31 eyes from 8 centers were included in this study. The mechanism of macular hole development was blunt trauma in 30 eyes (97%) and industrial laser in 1 eye (3%). The rate of anatomic closure after primary vitrectomy was 81% (25 eyes); the final anatomic closure rate after a secondary vitrectomy was 94% (29 eyes). There was a statistically significant improvement in visual acuity from initial presentation (20/164) to final follow-up (20/100) ( P = .009). Conclusions: Microincisional vitrectomy surgery for pediatric macular holes results in substantial anatomic success and modest improvement in visual acuity.


2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Gian Marco Tosi ◽  
Gianluca Martone ◽  
Angelo Balestrazzi ◽  
Alex Malandrini ◽  
Marco Alegente ◽  
...  

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.


2013 ◽  
Vol 5 (1) ◽  
pp. 114-116
Author(s):  
A Jindal ◽  
A Bhawdekar ◽  
A Pathengay

Background: Triamcinolone acetonide (TA) is commonly used in vitreous surgery to visualize the posterior hyaloid and internal limiting membrane. Some TA can accumulate in the macular hole during surgery which can persist postoperatively. Case: A 17-year-old boy underwent successful macular hole surgery with TA-assisted induction of posterior vitreous detachment. Sub-foveal deposit of TA was observed postoperatively, which got absorbed at 7 weeks with complete closure of the macular hole, and best corrected visual acuity improved from 20/100 preoperatively to 20/60. Conclusion: Residual TA after macular hole surgery may not hamper the anatomical and functional outcome. Similar cases have been reported in the literature and most of them show no harmful effect of TA on macular hole closure and visual recovery. Nepal J Ophthalmol 2013; 5(9):114-116 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7837


2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Haroon Tayyab ◽  
Asad Aslam Khan ◽  
Sana Jahangir

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.


2017 ◽  
Vol 28 (2) ◽  
pp. 225-228 ◽  
Author(s):  
Christoph Leisser ◽  
Nino Hirnschall ◽  
Birgit Döller ◽  
Ralph Varsits ◽  
Marlies Ullrich ◽  
...  

Purpose: Classical or temporal internal limiting membrane (ILM) flap transposition with air or gas tamponade are current trends with the potential to improve surgical results, especially in cases with large macular holes. Methods: A prospective case series included patients with idiopathic macular holes or persistent macular holes after 23-G pars plana vitrectomy (PPV) and ILM peeling with gas tamponade. In all patients, 23-G PPV and ILM peeling with ILM flap transposition with gas tamponade and postoperative face-down position was performed. Results: In 7 of 9 eyes, temporal ILM flap transposition combined with pedicle ILM flap could be successfully performed and macular holes were closed in all eyes after surgery. The remaining 2 eyes were converted to pedicle ILM flap transposition with macular hole closure after surgery. Three eyes were scheduled as pedicle ILM flap transposition due to previous ILM peeling. In 2 of these eyes, the macular hole could be closed with pedicle ILM flap transposition. In 3 eyes, free ILM flap transposition was performed and in 2 of these eyes macular hole could be closed after surgery, whereas in 1 eye a second surgery, performed as pedicle ILM flap transposition, was performed and led to successful macular hole closure. Conclusions: Use of ILM flaps in surgical repair of macular hole surgery is a new option of treatment with excellent results independent of the diameter of macular holes. For patients with persistent macular holes, pedicle ILM flap transposition or free ILM flap transposition are surgical options.


2021 ◽  
Author(s):  
María José Crespo Carballés ◽  
Marina Sastre-Ibáñez ◽  
Mar Prieto del Cura ◽  
Laura Jimeno Anaya ◽  
Natalia Pastora Salvador ◽  
...  

Abstract Purpose: To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. Methods: Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12 months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. Results: There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12 months after surgery (p = 0.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (p=0,62). Conclusions: ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes.


2014 ◽  
Vol 6 (1) ◽  
pp. 98-101 ◽  
Author(s):  
Animesh Jindal ◽  
Avinash Pathengay ◽  
Kopal Mithal ◽  
Jay Chhablani ◽  
Rajeev Reddy Pappuru ◽  
...  

Introduction: Brilliant blue G is a new dye used for staining the internal limiting membrane to ease its peeling in cases like a macular hole. Cases: Three patients presented with full-thickness idiopathic macular hole. They underwent pars planavitrectomy, Brilliant Blue G (BBG) stained internal limiting membrane peeling and fluid gas exchange. Observations: Postoperatively,the macular hole closed but foveal thinning and perifoveal hyperpigmentation presumably due to BBG toxicity were observed in all three patients. All of them had a subnormal final best corrected visual acuity. Conclusion:This case series highlights the unusual occurrence of macular toxicity following brillantblue G-assisted macular hole surgery. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10779   Nepal J Ophthalmol 2014; 6 (2): 98-101


2017 ◽  
Vol 98 (3) ◽  
pp. 397-400
Author(s):  
D V Petrachkov ◽  
A V Zolotarev ◽  
P A Zamytskiy ◽  
E V Karlova ◽  
I S Kazakov

Aim. Analysis of anatomical and functional results of surgical treatment of full-thickness macular holes. Methods. We conducted a retrospective analysis of medical records of 194 outpatients (194 eyes) on whom surgical treatment of macular hole was performed in Samara Clinical Ophthalmic Hospital n.a. T.I. Eroshevskiy during 2015-2016. Results. On day 5 after surgery in 96 (97.9%) patients with a hole of more than 400 µm operated according to inverted flap technique, and in 93 (96.9%) patients with hole of less than 400 µm, on whom removal of the internal limiting membrane around the hole was performed, we observed macular hole closure. The best corrected visual acuity of patients with the hole of more than 400 µm increased to 0.18±0.13 (p


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