A human amniotic membrane plug to repair retinal detachment associated with large macular tear

To describe a surgical technique, using a human amniotic membrane (hAM) plug, in two cases of retinal detachment with a large macular tear.

Surgical technique description with surgical video. A 23-gauge pars plana vitrectomy with peripheral retinectomy was performed. An hAM plug was implanted under the neuroretina to seal the posterior retinal break. Standard silicone oil tamponade was performed at the end of the surgery. The patients were positioned face down after the operation for the first 2 weeks. Optical coherence tomography (OCT) scans were performed in the follow-ups.

The 1 week postoperative OCT showed a neuroretina ingrowth over the hAM plug. The 3-month OCT showed a regenerated neurosensory retina entirely covering the hAM plug. Visual acuity improved from light perception to 20/400 (LogMAR 1,3) 3 months after the operation in both patients. The silicone oil was extracted 4 months after surgery, and no recurrences were observed. The patients' visual acuity remained stable at 20/400 after the silicone oil extraction.

In these complex cases, hAM transplantation can be a valid option not only to help the retinal reattachment but also for a partial regenerative effect which, in these cases, was accompanied by a visual acuity recovery.