Ophthalmic Research
Original Paper
Autologous Internal Limiting Membrane Fragment Transplantation for Large, Chronic, and Refractory Macular HolesDe Novelli F.J.a · Preti R.C.a · Ribeiro Monteiro M.L.a · Pelayes D.E.c, d · Junqueira Nóbrega M.b · Takahashi W.Y.aaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, and bOphthalmology, Universidade da Região de Joinville, Joinville, Brazil; cArea of Ophthalmology, Buenos Aires University, and dCenter for Applied Research and High Complexity in Ophthalmology, Maimónides University, Buenos Aires, Argentina
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Article / Publication Details
Received: December 23, 2014
Accepted: September 01, 2015
Published online: November 17, 2015
Issue release date: December 2015
Number of Print Pages: 8
Number of Figures: 5
Number of Tables: 1
ISSN: 0030-3747 (Print)
eISSN: 1423-0259 (Online)
For additional information: https://www.karger.com/ORE
Abstract
Objective: To evaluate a technique of autologous internal limiting membrane (ILM) fragment transplantation for the treatment of large, chronic, and/or refractory macular holes (MH). Design: This was a 6-month prospective interventional case series. Method: Ten eyes of 10 patients with MH underwent pars plana vitretomy (PPV) and ILM peeling followed by transplantation of an autologous ILM fragment to the MH. Six patients had primary MH with an internal diameter greater than 500 µm and a duration of more than 18 months, including 1 patient with nonproliferative diabetic retinopathy previously treated with panretinal photocoagulation. Four eyes with MH had previously been submitted to PPV (i.e. 1 for retinal detachment and 3 to attempt to close large MH). One of the latter also displayed juxtapapillary choroidal neovascularization due to age-related macular degeneration. The primary and secondary outcomes were MH closure and improvement of the best corrected visual acuity (BCVA), respectively. Results: Complete MH closure was achieved in all cases. A statistically significant improvement in the average BCVA was observed after 6 months of follow-up (p = 0.018; paired t test). The BCVA improved in 8 eyes (80%), and in 6 of those eyes it improved by ≥15 letters. In 1 patient, the BCVA remained unchanged after the surgery, but the visual field reportedly improved. One patient experienced a slight worsening (0.16 logMAR). Two cases developed atrophy of the retinal pigment epithelium despite MH closure and BCVA improvement. Conclusion: Treatment with autologous ILM fragment transplantation seems to be an efficient alternative for large, chronic, and refractory MH.
© 2015 S. Karger AG, Basel
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Article / Publication Details
Received: December 23, 2014
Accepted: September 01, 2015
Published online: November 17, 2015
Issue release date: December 2015
Number of Print Pages: 8
Number of Figures: 5
Number of Tables: 1
ISSN: 0030-3747 (Print)
eISSN: 1423-0259 (Online)
For additional information: https://www.karger.com/ORE
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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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