COMBINED AMNIOTIC MEMBRANE GRAFT AND AUTOLOGOUS RETINAL TRANSPLANT FOR REPAIR OF REFRACTORY CHRONIC MYOPIC MACULAR...

The objective of this study was to report a technique for reconstruction of large, persistent, chronic, myopic macular holes using a combined human amniotic membrane graft and autologous retinal transplant.

Three patients with large, myopic macular holes who failed prior surgical attempts and underwent subretinal amniotic membrane graft with overlying autologous retinal transplant and short-term perfluorocarbon tamponade were included in this study. Preoperative and postoperative visual acuity and images were analyzed at 3, 6, and 9 months.

All three myopic macular holes remained closed at 9 months with resolution of central scotoma. The first case, a 69-year-old woman, presented with a persistent macular hole whose minimum linear diameter was 1,085 µm. Her preoperative visual acuity of 20/200 improved by 9 months to 20/100. Second, a 72-year-old man with a history of recurrent retinal detachment repair with silicone oil and persistent macular hole of 1,134 µm presented with preoperative visual acuity of 20/200, which was unchanged at 9 months. Finally, a 76-year-old woman with a persistent macular hole of 935 µm with preoperative visual acuity of 20/80 improved by 9 months postoperative to 20/50. No complications were encountered related to the grafts.

Combined amniotic membrane graft and autologous retinal transplant may provide a surgical option for repair of refractory, large, chronic myopic macular holes with underlying atrophy.