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Published on: February 12, 2018
Plasma Rich in Growth Factors in Macular Hole Surgery
Ronald M Sánchez-Ávila1,2, Carlos A Robayo-Esper1, Eva Villota-Deleu1
1Ophthalmology Research Foundation, Fernández-Vega University Institute, University of Oviedo, 33071 Oviedo, Spain.
Abstract:
The aim of this study was to evaluate the use of PRGF (plasma rich in growth factors) as an adjuvant to PPV (pars plana vitrectomy) in recurrent, persistent, or poor prognosis MH (macular hole). Patients with MH were treated with PPV plus adjuvant therapy (PRGF membrane (mPRGF) and injectable liquid PRGF (iPRGF)). The anatomical closure of MH and postoperative BCVA (best-corrected visual acuity) were evaluated. Eight eyes (eight patients) were evaluated: myopic MH (MMH, n = 4), idiopathic MH (IMH, n = 2), iatrogenic n = 1, traumatic n = 1. The mean age was 53.1 ± 19.3 years. Hence, 66.7% (n = 4) of patients previously had internal limiting membrane peeling. Five patients (62.5%) received mPRGF and iPRGF, and three patients (37.5%) received iPRGF. Gas tamponade (C3F8) was placed in seven cases and one case of silicone oil. Anatomic closure of MH was achieved in seven eyes (87.5%) and BCVA improved in six cases. In the MMH group, visual acuity improved in two lines of vision. Follow-up time was 27.2 ± 9.0 months. No adverse events or MH recurrences were recorded during follow-up. The use of PRGF as an adjuvant therapy to PPV can be useful to improve anatomical closure and visual acuity in MH surgery.
Insights
Plasma rich in growth factors (PRGF) combined with pars plana vitrectomy (PPV) surgery improved macular hole (MH) closure and vision. This adjuvant therapy showed promising results with no adverse events in the study cohort.
Area of Science:
- Ophthalmology
- Regenerative Medicine
Background:
- Macular holes (MH) can lead to persistent visual impairment.
- Pars plana vitrectomy (PPV) is a standard surgical treatment for MH.
- Adjuvant therapies are explored to enhance PPV outcomes, especially in complex cases.
Observation:
- This study evaluated plasma rich in growth factors (PRGF) as an adjuvant to PPV in 8 patients with recurrent, persistent, or poor prognosis MH.
- Patients received either PRGF membrane (mPRGF) and injectable liquid PRGF (iPRGF), or iPRGF alone.
- The cohort included myopic MH, idiopathic MH, iatrogenic MH, and traumatic MH.
Findings:
- Anatomical closure of the MH was achieved in 87.5% of eyes.
- Best-corrected visual acuity (BCVA) improved in 75% of cases.
- Two lines of visual acuity improvement were noted in the myopic MH subgroup.
Implications:
- PRGF appears to be a safe and effective adjuvant therapy for enhancing MH surgical outcomes.
- This approach may improve both anatomical success and visual recovery in MH surgery.
- Further research could validate PRGF's role in complex MH cases.
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