Retinal graft dislocation managed by repeat autologous retinal transplant for refractory macular hole

A septuagenarian man presented with a visual acuity of hand motions and a large refractory macular hole (MH). We performed an autologous retinal transplant (ART) and covered the graft with fibrin glue without any endotamponade. The autograft was found to have dislocated from the MH when the patient was reviewed 1 week later. He was admitted for repeat ART surgery, where 1000 centistoke silicone oil was injected instead of fibrin glue and advised the patient to maintain a face-down position for 1 week. 1 month after the second surgery, the patient had a visual acuity of 20/200, N18. The graft was integrated at the MH site, with both donor sites well lasered and the retina attached.Our case suggests that a short-acting bioadhesive such as fibrin glue may not provide sufficient duration of support until adequate retino-retinal adhesion forms between the host and retinal graft.