Comparison of platelet-rich plasma and inverted internal limiting membrane flap for the management of large macular holes: A pilot study

Babu, Naresh; Kohli, Piyush; N, Ramachandran; Adenuga, Olukorede O; Ahuja, Ashish; Ramasamy, Kim

doi:10.4103/ijo.ijo_1357_19

Cited by 14 publications

(7 citation statements)

References 39 publications

(58 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…В литературе имеются сведения о положительном опыте применения PRP и перевернутого лоскута ВПМ в лечении СМР большого диаметра (более 800 мкм) [22]. В ходе нашего исследования удалось добиться высоких морфофункциональных результатов у всех пациентов в исследуемых группах: было достигнуто повышение МКОЗ, причем достоверных различий между группами зафиксировано не было (p < 0,05).…”

Section: Discussionunclassified

Comparison of Early Treatment Outcomes for Large Macular Hole Using Various Surgical Techniques

Petrachkov¹,

Alkharki²,

Matyushchenko³

et al. 2021

Oftalʹmologiâ

View full text Add to dashboard Cite

Macular hole (MH) is one of the most common pathologies of the macular area of the retina which leads to a significant decrease in visual acuity. The article presents early comparative morphofunctional results of surgical treatment of 60 patients (22 men and 38 women) with MH of the III–IV stages according to Gass and the minimum diameter (MinD) MH 404–696 microns. All patients included in the study had pseudophakia and have not previously undergone endovitreal interventions. Patients with MH with a diameter of 404–696 μm were randomized and divided into 3 equal groups: after three-port 25G pars plana posterior vitrectomy the patients of the first group underwent peeling of the inner limited membrane (ILM) with the convergence of the edges of MH and vitreous cavity tamponade with 16 % gas-air mixture of perfluoropropane (C2F6). In the area of the macular defect, patients of the second group underwent application of autologous conditioned plasma (ACP) in the PFСs environment and the convergence of the edges of MH. In patients of the third group, MH was closed using the technique of an inverted ILM flap. In patients of groups 2 and 3 the operation was completed by tamponade of the vitreous cavity with sterile air. Standard and special research methods, such as optical coherence tomography of the macular zone, were performed before surgery, 5 days and 1 month after surgery in all patients from groups 2 and 3. Patients from group 1 were examined before surgery and 1 month after surgical treatment, due to the long-lasting gas-air mixture in the vitreous cavity. Restoration of the correct structure of the fovea with the formation of U- and V-shaped profile during OCT after 1 month was noted in all cases. The data obtained demonstrate the peculiarities of using the inverted ILM flap and ACP methods in comparison with the traditional method of MH closure with a gas-air mixture.

show abstract

Section: Discussionunclassified

Comparison of Early Treatment Outcomes for Large Macular Hole Using Various Surgical Techniques

Petrachkov¹,

Alkharki²,

Matyushchenko³

et al. 2021

Oftalʹmologiâ

View full text Add to dashboard Cite

show abstract

“…Як відомо, мігруючі клітини Мюллера виділяють нейротрофічні фактори, що сприяють гліальній гіпертрофії й закриттю РМ надалі. Протягом останнього часу з'являються дані щодо успішного лікування РМ із використанням аутоплазми [41][42]. Так, A. Gaudric, Р. Massin, М. Paques та ін.…”

Section: сучасні підходи до лікування фовеозберігаючі методикиunclassified

Ідіопатичні Розриви Макули, Етіологія Та Патогенез, Класифікація, Актуальні Методики Лікування (Огляд Літератури)

et al. 2023

View full text Add to dashboard Cite

В огляді висвітлено розділ вітреоретинальної хірургії – хірургічне лікування ідіопатичних розривів макули (ІРМ). Метою огляду є оцінювання сучасних методик лікування ІРМ і прогностичний аналіз закриття розривів у післяопераційний період. ІРМ є анатомічним дефектом фовеолярної ділянки сітківки ока, що призводить до зниження центрального зору. У роботі розглянуто питання етіології та патогенезу, класифікації, історичні аспекти методів хірургічного лікування й сучасні підходи до лікування ІРМ. Основну роль у розвитку патології відіграють тангенціальні вітреомакулярні тракції. Класифікація розривів макули ґрунтується на даних біомікроскопії та ОКТ-сканування. Аналіз літературних джерел свідчить, що вітреоретинальна хірургія має значний арсенал методик лікування ідіопатичних розривів макули різного діаметра, однак відсутній єдиний підхід до вибору найбільш оптимальної техніки закриття розривів. Сьогодні доцільним є застосування фовеозберігаючих методик, які дають змогу уникнути певних морфологічних і функціональних змін, характерних для класичного пілінгу внутрішньої межової мембрани.

show abstract

“…A PRP clot is prepared from the patient's own blood and is advantageous to wound healing due to the presence of platelets and the extended release of growth factors which aid in wound healing [11]. A study by Babu et al in [12] compared the use of PRP to that of an inverted internal limiting membrane flap for treatment of large macular holes and found that not only was the safety and efficacy of both approaches equivalent, but also patients treated with PRP did not have reported postoperative inflammation, hypotony, endophthalmitis or retinal detachments [12]. Several procedures exist for the preparation of PRP for use in ophthalmic procedures.…”

Section: Alternative Biological Adhesivesmentioning

confidence: 99%

A novel approach to sclerotomy closure in pars plana vitrectomy: a pilot study

2022

View full text Add to dashboard Cite

Background Methods of sclerotomy closure following a vitrectomy, including the use of sutures, have been associated with complications such as inflammation, foreign body sensation, and infection. Here, we test an innovative approach to scleral wound closure following pars plana vitrectomy that involves plugging the wound. We investigated several materials with the intent of using products that were either already approved by the FDA for other types of procedures or were biocompatible patient-derived materials. Methods We examined whether scleral wounds could be sealed by a clot or internal “plug” rather than a suture or an external adhesive. We tested patient-derived materials (platelet-rich plasma (PRP) and whole blood) as well as polyethylene glycol (PEG) sealant. Whole blood and PRP were prevented from clotting prematurely using sodium citrate, and were clotted for the study with thrombin. Polyethylene glycol (PEG) sealant was prepared according to manufacturer’s recommendations. We used fresh-frozen cadaveric porcine eyes. We tested several methods to form plugs using the above materials, as well as various methods to deliver the plugs into the sclerotomy incisions. We used a novel technique of manual vitrectomy. Successfully generated and implanted clots were tested for efficacy with the Seidel test. Results Polyethylene glycol (PEG) sealant fractured during our attempts at molding and inserting the plug. In contrast, both whole blood and PRP yielded successful plugs for insertion. We molded a whole blood clot plug by allowing it to clot inside a 20-gauge angiocath catheter and we successfully delivered it through a 23G trocar. At baseline, no wound leakage was apparent. However, the whole blood clot dislodged during the Seidel test. We successfully molded and delivered a PRP clot plug using a tapered 2-20 μl pipette tip, using MAXGrip Forceps to push it through into the wound. No scleral wound leakage was noted at our baseline physiologic infusion pressure. Furthermore, the PRP clot plug prevented scleral wound leakage up to a pressure of 60 mmHg and was confirmed with the Seidel test. Conclusion Our findings suggest that insertion of a clot plug made from either whole blood or PRP may be an effective strategy for scleral wound closure following pars plana vitrectomy. Further testing in preclinical models is warranted to further refine the materials and methods, since this appears to have the potential to improve the closure of the scleral wounds after pars plana vitrectomy.

show abstract

Comparison of platelet-rich plasma and inverted internal limiting membrane flap for the management of large macular holes: A pilot study

Cited by 14 publications

References 39 publications

Comparison of Early Treatment Outcomes for Large Macular Hole Using Various Surgical Techniques

Comparison of Early Treatment Outcomes for Large Macular Hole Using Various Surgical Techniques

Ідіопатичні Розриви Макули, Етіологія Та Патогенез, Класифікація, Актуальні Методики Лікування (Огляд Літератури)

A novel approach to sclerotomy closure in pars plana vitrectomy: a pilot study

Contact Info

Product

Resources

About