Dataset Information

To evaluate the functional and anatomical outcomes for autologous retinal autograft with Finesse™ Flex Loop for failed macular holes.

ABSTRACT:

Purpose

To evaluate the functional and anatomical outcomes for autologous retinal autograft with Finesse™ Flex Loop for failed macular holes.

Methods

This is a retrospective study analyzing medical records of consecutive patients with refractory macular hole (at least 1 prior surgery) and eyes with retinal detachment with coexisting macular holes (MH). Optical coherence tomography (OCT) of the macula was performed before and after surgery. The primary study outcome evaluated were the functional and anatomic macular hole closure, and secondary outcomes were improvement in visual acuity and restoration of the outer retinal bands, external limiting membrane, and ellipsoid zone in eyes with acquisition of autologous retinal transplant using Finesse Loop.

Results

The study included eight eyes of eight patients; retinal autograft was performed in six (75.0%) and autologous retinal transplantation (ART) with rhegmatogenous retinal detachment (RRD) was performed in two (25.0%) eyes. The average MH basal diameter in the study was 1310.88 ± 138.63 μm. The successful hole closure rate was observed to be 75% (6 eyes) and 100% retinal reattachment was observed in ART with RRD. Statistically significant (P = 0.001) improvement was noted for preop and postop visual acuity gain for ART acquisition and postop macular hole closure. The restoration of the external limiting membrane (ELM) and ellipsoid zone (EZ) was observed in 37.5% (3 eyes) of patients.

Conclusion

Finesse™ Flex Loop can be used to harvest retinal tissue and it provides good anatomical and functional outcomes for failed macular hole.

SUBMITTER: Dhami A

PROVIDER: S-EPMC9672773 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

To evaluate the functional and anatomical outcomes for autologous retinal autograft with Finesse™ Flex Loop for failed macular holes.

Dhami Abhinav A Sharma Pragya P Dhami Nimrata B NB Dhami Gobinder S GS

Indian journal of ophthalmology 20220801 8

<h4>Purpose</h4>To evaluate the functional and anatomical outcomes for autologous retinal autograft with Finesse™ Flex Loop for failed macular holes.<h4>Methods</h4>This is a retrospective study analyzing medical records of consecutive patients with refractory macular hole (at least 1 prior surgery) and eyes with retinal detachment with coexisting macular holes (MH). Optical coherence tomography (OCT) of the macula was performed before and after surgery. The primary study outcome evaluated were ...[more]

PMID: 35918967

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Project description:BackgroundLamellar macular holes (LMHs) are small, partial-thickness defects of the macula defined by characteristic features on optical coherence tomography (OCT), including a newly recognised type of epiretinal membrane termed 'epiretinal proliferation'. There may be a rationale to recommend surgery for individuals with LMHs, particularly those with functional or anatomical deterioration, or poor baseline vision causing significant disability, to stabilise the LMH and prevent further visual deterioration; however, there is currently no evidence-based consensus.ObjectivesTo assess the effect of surgical interventions on post-operative visual and anatomical outcomes in people with a confirmed LMH.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, Scopus SciVerse, ISRCTN registry, US National Institutes of Health Ongoing Trials Register, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We also searched reference lists of included trials to identify other eligible trials which our search strategy may have missed. The date of the search was 20 July 2021.Selection criteriaWe included randomised controlled trials (RCTs) involving participants with a confirmed LMH diagnosis which reported one or more surgical intervention(s), alone or in combination, in at least one arm of the RCT.Data collection and analysisWe used standard methods as expected by Cochrane. Two study authors independently extracted data and assessed the risk of bias for included trials. Trial authors were contacted for further information and clarification.Main resultsA single RCT was eligible for inclusion. Thirty-six participants were randomised in a 2:1 ratio; 24 were allocated to undergo surgery (pars plana vitrectomy, peeling of the epiretial proliferation followed by fovea-sparing removal of the internal limiting membrane) and 12 (10 following two participant dropouts) to observation. Overall, the certainty of the evidence was low for all outcomes due to selection and detection bias, and the low number of participants enrolled in the study which may affect the accuracy of results and reliability of conclusions. At six-month follow-up, change in vision was better in the surgery group (-0.27 logMAR improvement) than observation (0.02 worsening) (mean difference (MD): -0.29 logMAR, 95% confidence intervals (CI): -0.33 to -0.25). Central retinal thickness increased in the surgery group over 6 months 126 μm increase) compared with observation group (decrease by 11μm) (MD: 137 μm, 95% CI: 125.87 μm to 148.13 μm). Finally, at six-month follow-up, retinal sensitivity was better in the surgery group (3.03 dB increase) compared with the observation group (0.06 dB decrease) (MD: 3.09 dB, 95% CI: 2.07 to 4.11 dB). Vision-related quality of life and metamorphopsia were not reported. No adverse outcomes or complications were reported in the study, however, authors could not provide information on whether any individuals developed deterioration in vision of 0.2 logMAR or worse.Authors' conclusionsThe included single trial demonstrated improvements in visual and anatomical outcome measures for participants with a LMH who underwent surgery compared with observation only. Therefore, we can conclude that participants who undergo surgery may achieve superior post-operative best corrected visual acuity and anatomical outcomes compared with observation only. However, the results of a single and small RCT provides limited evidence to support or refute surgery as an effective management option for LMHs. Future RCTs with a larger number of participants and with fewer methodological limitations and biases are necessary to inform future clinical practice.

Dataset Information

To evaluate the functional and anatomical outcomes for autologous retinal autograft with Finesse™ Flex Loop for failed macular holes.

Purpose

Methods

Results

Conclusion

Publications

To evaluate the functional and anatomical outcomes for autologous retinal autograft with Finesse™ Flex Loop for failed macular holes.

Similar Datasets

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