Management of traumatic macular hole and retinal detachment using amniotic membrane transplantation: A case report

Amniotic membrane transplantation (AMT) has become an increasingly utilized technique in ophthalmologic procedures. We describe a case of a rhegmatogenous retinal detachment (RRD) associated with a traumatic macular hole (TMH) that was identified intraoperatively and successfully repaired with an amniotic membrane transplant (AMT).

An 18-year-old-female presented to our retina clinic for evaluation and treatment following firework-related trauma to the left eye. Previous globe exploration found no globe involvement. Pre-operative examination revealed a dense traumatic cataract and superior iridodialysis. Retinal evaluation was limited, but preoperative B-scan imaging suggested a macula-involving retinal detachment (RD). Intraoperatively, a TMH was identified as the cause of the RD and was repaired using AMT. Post-operatively, the patient's visual acuity improved from light perception to hand motion. Optical coherence tomography (OCT) confirmed that the AMT was in place as well as successful hole closure. The retina remained attached following silicone oil removal.

TMH-associated RRDs are rare and challenging to manage due to their complexity and difficult preoperative evaluation. AMT offers a promising approach given its availability and minimal side effects. Given the patient's improvement in visual and anatomic outcomes, this case demonstrates the potential for AMT's expanded role in the management of TMH-associated RRDs and emphasizes the need for further research to optimize techniques and enhance outcomes.