Refractory macular hole repaired by autologous retinal graft and blood clot

Abstract

BackgroundTo evaluate the surgical technique using autologous retinal graft (ARG) and autologous blood clot (ABC) for the management of refractory macular holes (MHs).MethodsThis study was a retrospective, consecutive, interventional case series. Six eyes of 6 patients who underwent vitrectomy combined with ARG and ABC for the treatment of refractory MH were reviewed. Visual and anatomic outcomes were evaluated.ResultsThe mean age was 59.0 ± 9.9 years. All cases had multiple vitreoretinal procedures including vitrectomy and gas fluid exchange before patient presentation. The average numbers of vitrectomies were 2.3 ± 0.5, and those of gas fluid exchange were 3 ± 1.7. Closure of the macular hole was achieved in four (66.7%) cases at last follow-up. The mean follow-up time was 25.2 ± 15.6 months. The averaged BCVA before and after 12 months of the surgery improved from 20/591 to 20/244.ConclusionsThis surgical technique using ARG and ABC provide an option for the treatment of refractory MHs.Electronic supplementary materialThe online version of this article (10.1186/s12886-018-0898-8) contains supplementary material, which is available to authorized users.

A human Amniotic Membrane plug to manage high myopic macular hole associated with retinal detachment

“…) and retinal autograft (Grewal & Mahmoud ; Wu et al. ). The purpose behind these techniques was to find a substrate to seal the MH in order to prevent fluid passing through the MH to the subretinal space, and to allow tissue proliferation in order to obtain retinal restoration and VA recovery.…”

“…Many techniques have been proposed to increase closure rate in recurrent HMMH with RD, such as autologous blood (Lai et al 2015), ILM free patch (Morizane et al 2014;Dai et al 2016;Chen et al 2018) and retinal autograft (Grewal & Mahmoud 2016;Wu et al 2018). The purpose behind these techniques was to find a substrate to seal the MH in order to prevent fluid passing through the MH to the subretinal space, and to allow tissue proliferation in order to obtain retinal restoration and VA recovery.…”

A Double Inverted Flap Surgical Technique for the Treatment of Idiopathic Lamellar Macular Hole Associated with Atypical Epiretinal Membrane

“…Two of the 3 cases of FTMH developed flat FTMH after silicon oil tamponade. Therefore, we suggest taking into account alternative techniques for the treatment of persistent FTMH, like autologous platelet concentrate or autologous whole blood and neuroretinal patch graft [29, 30]. The removal of AERM is much more problematic than the removal of CERM.…”

Clinical Management of Myopia in Adults: Treatment of Retinal Complications

“…In order to prevent flap dislocation intraoperatively and postoperatively, the intraocular pressure should be lowered to reduce fluid turbulence [72]. The edge of the flap could be tucked underneath the edge of MH [72].…”

“…In order to prevent flap dislocation intraoperatively and postoperatively, the intraocular pressure should be lowered to reduce fluid turbulence [72]. The edge of the flap could be tucked underneath the edge of MH [72]. A technique combining autologous blood and autologous retinal free flap transplantation was described to secure the flap with blood clot [72].…”