An Internal Limiting Membrane Plug and Gas Endotamponade for Recurrent or Persistent Macular Hole.

ABSTRACT:

Introduction

Recurrent or persistent macular holes (MHs) are rare today due to the tendency to carefully peel the internal limiting membrane. Conversely, their treatment is still a challenge for a vitreoretinal surgeon.

Materials and methods

This is a retrospective, consecutive, and nonrandomized study of patients affected by recurrent or persistent MHs treated using small-gauge pars plana vitrectomy (25- or 23-gauge) and an autologous ILM plug, at the Eye Clinic of Azienda Ospedaliera Universitaria Careggi (Florence, Italy) between January 2016 and May 2018. We included 8 eyes of 8 patients in the study. Five patients had a recurrent MH while 3 had a persistent MH. The case series includes patients with myopic eyes and with large macular holes (>400??). Patients were followed up with ophthalmoscopic examinations and swept-source optical coherence tomography (SS-OCT).

Results

The mean age of the patients was 74?years (±4.81 standard deviation (SD)), 3 patients were men and 5 women. The average axial length was 26.28?mm (±2.84 SD). Four patients had an AL???26?mm. The mean MH diameter was 436.5 (±49.82 SD). Average preoperative best-corrected visual acuity (BCVA) was 0.81 logMAR (±0.16 SD) and 20/125 Snellen. The ILM plug has been found integrated in the MH in all the follow-ups.

Conclusion

In our study, an ILM autologous macular transplant was used successfully in 5 cases of macular hole recurrence and 3 cases of macular hole persistence. The anatomical success was achieved in all the cases; 4 patients improved their BCVA, and 4 patients maintained it. No macular alterations such as RPE or retinal atrophy/dystrophy were observed after 6?months.

SUBMITTER: Giansanti F 

PROVIDER: S-EPMC6431435 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature