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Published on: February 12, 2018
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MANAGEMENT OF REFRACTORY LARGE MACULAR HOLE WITH AUTOLOGOUS NEUROSENSORY RETINAL FREE FLAP TRANSPLANTATION
Yo-Chen Chang1,2,3, Pei-Kang Liu3, Tzu-En Kao3,4
1Department of Ophthalmology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Retina (Philadelphia, Pa.)
|December 27, 2019
Summary
Autologous neurosensory retinal free flap transplantation successfully closed 90% of large macular holes. This innovative technique improved visual acuity in patients with refractory macular holes, offering a new surgical option.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Hole Treatment
Background:
- Refractory large macular holes (MH) present significant challenges in achieving anatomical closure and visual recovery.
- Standard surgical interventions often fail in persistent or large MH cases, necessitating novel approaches.
Purpose of the Study:
- To evaluate the efficacy of autologous neurosensory retinal free flap transplantation in treating refractory large macular holes.
- To assess both the morphological and functional outcomes following this surgical procedure.
Main Methods:
- A case series of 10 patients with refractory large MH underwent pars plana vitrectomy.
- A neurosensory retinal free flap was harvested and stabilized using adhesive agents, followed by silicone oil tamponade.
- Macular hole closure and best-corrected visual acuity were the primary outcome measures.
Main Results:
- Macular hole closure was achieved in 90% (9 out of 10) of the patients.
- Mean best-corrected visual acuity improved significantly from 1.65 preoperatively to 0.88 logarithm of minimum angle of resolution at 12 months post-surgery (P < 0.001).
- All patients had previously undergone at least two unsuccessful vitreoretinal procedures.
Conclusions:
- Autologous neurosensory retinal free flap transplantation is a promising new surgical option for refractory large macular holes.
- This technique can lead to significant anatomical and functional improvements, particularly when internal limiting membrane peeling is insufficient.
- Silicone oil tamponade plays a crucial role in the success of this procedure.
