HUMAN AMNIOTIC MEMBRANE OVERLAY GRAFTING FOR LARGE RETINAL BREAKS IN EYES WITH RECURRENT RETINAL DETACHMENT

To describe a new technique for placing large epiretinal human amniotic membrane grafts in two eyes with high myopia and recurrent retinal detachment resulting from large breaks over staphyloma not amenable to laser or cryoretinopexy.

Surgical technique demonstration with video and images. We examined two high myopic eyes with large retinal breaks and recurrent rhegmatogenous retinal detachment that had undergone rhegmatogenous retinal detachment repair with silicone oil tamponade. Break was seen over nasal staphyloma in the first case and over an atrophic area along with retinoschisis at posterior pole in the second case. 25 G vitrectomy with silicone oil removal was done and a large multilayered hAM graft was placed over large retinal breaks. Both eyes receive gas tamponade. The patients were positioned face down for the first week after surgery. Optical coherence tomography scans were performed in the follow-up visits.

Retinal breaks could be successfully closed in both eyes at 2 weeks and 3 months follow-up. Large hAM grafts were stable and nicely visualized on postoperative optical coherence tomography scans and fundus photographs. These grafts were well tolerated with no displacement even at 12 months follow-up. There was no recurrence of rhegmatogenous retinal detachment noted in either eye.

The large overlay hAM grafting is an effective and safe technique for closing large retinal breaks over staphyloma or atrophic retina in high myopes.