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Carlà MM, Mateo C. Shortfalls of free autologous internal limiting membrane transplantation for highly myopic refractory macular holes in a long term follow-up. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06533-7. [PMID: 38832954 DOI: 10.1007/s00417-024-06533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/08/2024] [Accepted: 05/21/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND The aim of this study is to evaluate long-term anatomical and functional outcomes of autologous internal limiting membrane (ILM) transplantation in refractory highly myopic macular holes (HMMHs). METHODS Retrospective interventional analysis of 13 eyes with refractory HMMH undergoing autologous ILM transplantation with gas tamponade. Best-corrected visual acuity (BCVA, Snellen), optical coherence tomography and fundus photography were scheduled at baseline and every follow-up visit (1, 3, 6, 12, 18, 24 months and the most recent). Preoperatively, we collected minimum linear diameter (MLD) and basal diameter (BD). Post-operatively, rates of external limiting membrane (ELM)/ellipsoid zone (EZ) restoration, excessive gliosis and subfoveal retinal pigmented epithelium (RPE) atrophy were evaluated. RESULTS Average AXL was 31.45 ± 2.07 mm and mean follow-up was 47.2 ± 31.4 months. Anatomical success was reached in 7/13 eyes (54%), while 2 cases showed persisting HMMH, 2 cases had early recurrence and 2 cases late recurrence. BCVA went from 0.19 ± 0.18 to 0.22 ± 0.20 at final follow-up (p = 0.64), improving in 5/13 eyes (38%). One eye showed continuous ELM and EZ lines, while another eye showed an irregular ELM but no EZ. Post-operatively, 5 eyes (71%) developed progressive atrophy of the subfoveal RPE, while excessive gliosis was reported in 3 eyes (43%). Furthermore, one patient developed post-operative chronic macular edema-like changes in the perifoveal area. CONCLUSION Autologous ILM transplantation showed controversial anatomical outcomes and and poor visual results in refractory HMMH. Moreover, progressive subfoveal patchy atrophy and excessive gliosis are possible post-operative complications.
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Affiliation(s)
- Matteo Mario Carlà
- Ophthalmology Department, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, Rome, 00168, Italy.
- Ophthalmology Department, Catholic University "Sacro Cuore", Rome, Italy.
| | - Carlos Mateo
- Instituto de Microcirugía Ocular (IMO), Barcelona, Spain
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Chen YT, Lai CC, Hwang YS, Chen KJ, Wu WC. A Surgical Approach for Managing Refractory Macular Holes Using the Human Amniotic Membrane Patch Technique. Ophthalmic Surg Lasers Imaging Retina 2024:1-4. [PMID: 38917395 DOI: 10.3928/23258160-20240411-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
To introduce a novel surgical technique using the human amniotic membrane (hAM) patch technique to address refractory macular holes (MHs). After vitrectomy, the hAM patch was positioned on top of the MH with the chorion side facing downward. Viscoat (Alcon Laboratories) was applied on top of the hAM patch for better fixation. Fluid-air exchange was then performed and 20% SF6 or 10% C3F8 tamponade was administered after the surgery. Five patients with refractory MHs larger than 400 µm underwent the hAM patch technique. After a minimum 2-year follow-up, results showed 100% closure of MHs, 80% improvement in visual acuity, and a notable enhancement in best-corrected logMAR visual acuity from 0.98 to 0.72 (P = 0.039). Dislocation of hAM patch occurred among 3 out of 5 patients (60%). The hAM patch technique appears to be a promising approach for addressing refractory MHs. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].
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Fan Y, Wang J, Lei J, Ji J, Xie P, Hu Z. Biological ultrathin amniotic membrane flap to close refractory macular holes associated with high myopia. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06509-7. [PMID: 38805096 DOI: 10.1007/s00417-024-06509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
PURPOSE To propose an ultrathin biological amniotic membrane (btAM) thinner than 10 μm as the graft to treat highly myopic macular holes (MH). METHODS This pilot study included 14 patients affected by refractory macular holes associated with high myopia. btAM was used as a bandage covering the holes. The best-corrected visual acuity (BCVA), fundus photography, and optical coherence tomography (OCT) before and after surgery were compared. RESULTS The mean MH size was 865.93 ± 371.72 μm and all the MHs achieved anatomical closure. The btAM located centrally and fully on MHs from fundus photography yet no obvious visual masking was complained. The average BCVA 1 month, 3, and 6 months after surgery were 0.95 ± 0.24, 0.92 ± 0.23, 0.92 ± 0.23 logMAR, respectively, improved significantly compared to pre-operative BCVA (1.24 ± 0.42 logMAR, all P < 0.05). Ten out of 14 (71.4%) exhibited 2C closure patterns (formally closed and no bare RPE) on OCT. CONCLUSION The btAM thinner showed a favorable anatomical success with less risk of parafoveal atrophy or iatrogenic injuries and shortened the dissolving time.
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Affiliation(s)
- Yuanyuan Fan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Jiagui Wang
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Jie Lei
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Jiangdong Ji
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Ping Xie
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China.
| | - Zizhong Hu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China.
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Su T, He S, Mao P, Gu C, Meng C, Zhou C, Chen J, Zheng Z, Qiu Q. A three-step approach to close refractory persistent macular holes: a releasing-closing-tapping approach. Graefes Arch Clin Exp Ophthalmol 2023; 261:3415-3423. [PMID: 37561145 PMCID: PMC10667424 DOI: 10.1007/s00417-023-06197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/13/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE The aim of this study was to assess the efficacy and safety of a novel releasing-closing-tapping approach in the treatment of persistent macular holes (PMHs) after initial surgery with internal limiting membrane (ILM) peeling. METHODS We retrospectively analyzed patients with PMHs after initial surgery with ILM peeling who were treated with a novel releasing-closing-tapping approach. After repeated pars plana vitrectomy (PPV), the surgeon effectively released the adhesion between the edges and retinal pigment epithelium (RPE) by gently scraping the retinal neuroepithelium. Then, the hole was converted into a transverse slit, and the edges were gently tapped flat so that they attached to the RPE, and no space was left under the edges. Finally, air tamponade was carried out. The primary outcome measures included MH closure and the change in best-corrected visual acuity (BCVA) from preoperatively to postoperatively. RESULTS The study included 11 PMH patients with a mean age of 63.82 ± 3.31 years. The mean minimum linear diameter of PMHs was 666.3 ± 208.1 μm, and the mean basal diameter was 1547.2 ± 351.8 μm. MH closure was achieved in 90.9% (10/11) of eyes, with significant improvement of visual acuity from 1.19 ± 0.30 logMAR to 0.65 ± 0.29 logMAR postoperatively. CONCLUSION The releasing-closing-tapping approach with repeated PPV is a simple, effective, and safe surgical procedure for refractory PMHs after initial surgery with ILM peeling that can significantly improve the visual outcome and achieve a high surgical success rate.
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Affiliation(s)
- Tong Su
- Shandong Eye Hospital, Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University, Jinan, China
| | - Shuai He
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Peiyao Mao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Chufeng Gu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Chunren Meng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Chuandi Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Jili Chen
- Shibei Hospital, Jing'an District, Shanghai, People's Republic of China.
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
- National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China.
| | - Qinghua Qiu
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, People's Republic of China.
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Chen H, Lin W, Tang Y, Wei Y. THE LONG-TERM FOLLOW-UP OF AUTOLOGOUS BLOOD CLOT-ASSISTED LYOPHILIZED HUMAN AMNIOTIC MEMBRANE COVERING TREATMENT UNCLOSED MACULAR HOLE. Retina 2023; 43:1340-1347. [PMID: 37040605 PMCID: PMC10627547 DOI: 10.1097/iae.0000000000003806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
PURPOSE The objectives were to assess the long-term morphologic and functional outcome of eyes with unclosed macular hole (MH) in which the internal limiting membrane has been peeled in previous vitrectomy with autologous blood clot-assisted lyophilized human amniotic membrane (LhAM) graft covering. METHODS Twelve eyes with MH unclosed in previous surgery were selected and studied. Autologous blood clot-assisted LhAM graft was used to cover the MH in vitrectomy. The main clinical outcomes including best-corrected visual acuity, closure of MH, and the outcome of LhAM graft were recorded. RESULTS The mean minimum diameter of the MH was 641.7 ± 245.9 µ m and the mean axial length was 27.3 ± 3.50 mm. The LhAM graft was maintained in the former position and all the MH closed in 10 eyes, whereas the graft slipped and the MH unclosed in two eyes. The MH closure rate was 83.3% and the mean best-corrected visual acuity improved significantly from 1.47 ± 0.58 logMAR (Snellen 20/590) preoperatively to 1.17 ± 0.60 logMAR (Snellen 20/296) postoperatively. During 18 to 36 months follow-up, LhAM grafts were attached to the retinal surface in nine eyes, detached from the retinal surface in one eye, dislocated from the fovea in one eye, and inserted into the retina in one eye; and macular atrophy occurred in one eye. CONCLUSION Autologous blood clot-assisted LhAM graft covering provided a simple and effective treatment option for unclosed MH and reduce surgical trauma. Although the graft remained on the macular surface for a long time, it did not affect the recovery of MH and postoperative vision.
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Affiliation(s)
| | | | - Yongping Tang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yong Wei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Sharma A, Wu L, Bloom S, Stanga P, Figueroa MS, Govetto A, Mirajkar A, Nagpal M, Mehrotra N, Sharma A, Rezaei KA. RWC Update: Intraoperative Fluorescein Angiography, Plasma Rich in Growth Factor as Adjuvant to Vitrectomy in High Myopic Retinal Detachment Associated With Full-Thickness Macular Hole, Giant Tear of the Retinal Pigment Epithelium. Ophthalmic Surg Lasers Imaging Retina 2023; 54:259-264. [PMID: 37184990 DOI: 10.3928/23258160-20230412-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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Lee J, Chua M, Jansen M, Giovinazzo J, Powell B, Deobhakta A, Wong A, Zhu D, Ferrone PJ, Gentile R, Landa G, Dayan A, Pollack A, Rosen R. Amniotic Membrane Patching to Assist Closure of Recalcitrant Macular Holes. Ophthalmic Surg Lasers Imaging Retina 2023; 54:218-222. [PMID: 36884243 DOI: 10.3928/23258160-20230221-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND AND OBJECTIVE This study reports a case series of patients with persistent macular holes (MHs) who underwent human amniotic membrane subretinal placement to achieve successful anatomic MH closure. PATIENTS AND METHODS This was a retrospective case series of patients with persistently open full-thickness MHs who underwent human amniotic membrane placement. Patients were observed up to 6 months postoperatively. RESULTS Ten patients were included. The mean preoperative best-corrected visual acuity was 1.6 logMAR (20/800). Postoperatively, mean best-corrected visual acuity improved to 1.3 logMAR (20/400) at 1 month and 1.1 logMAR (20/250) by the 3- and 6-month visits. In all cases, the MH appeared closed at the 1-week visit and remained closed at their last follow-up. Optical coherence tomography showed closure in all cases. No adverse events were reported. CONCLUSIONS Human amniotic membrane sub-retinal placement may serve as a useful surgical technique to assist in the closure of recalcitrant macular holes. [Ophthalmic Surg Lasers Imaging Retina 2023;54(x):X-X.].
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Zhang H, Li Y, Chen G, Han F, Jiang W. Human amniotic membrane graft for refractory macular hole: A single-arm meta-analysis and systematic review. J Fr Ophtalmol 2023; 46:276-286. [PMID: 36739260 DOI: 10.1016/j.jfo.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE The treatment of refractory macular holes is controversial, with human amniotic membrane grafts emerging recently as an attractive option. We performed a meta-analysis and systematic review in this paper to assess the results of human amniotic membrane (hAM) in the treatment of refractory macular hole (MH). METHODS We searched the Cochrane Database of Systematic Reviews, Web of Science, PubMed, Embase, China National Knowledge Infrastructure databases, VIP database, Wanfang Data Knowledge Service Platform, Sinomed, Chinese Clinical Trial Registry, and Clinical Trials.gov. Studies reporting hAM for the treatment of refractory MH were included. The outcomes are MH closure rate, visual acuity (VA) improvement rate, and graft dislocation/contracture rate. RESULTS A total of 8 studies on 103 eyes were included, all of which had undergone failed vitrectomy and internal limiting membrane (ILM) peeling. In all studies, the VA improvement rate was 66% (95%CI: 45 to 84%), the MH closure rate was 94% (95%CI: 84 to 100%) and the hAM graft dislocation/contracture rate was 6% (95%CI: 0 to 15%). In the studies using cryopreserved hAM grafts, the MH closure rate was 99% (95%CI: 94 to 100%) and the hAM graft dislocation/contracture rate was 3% (0%, 10%). The VA improvement rates were 94% (95%CI: 79 to 100%) in the retinal detachment subgroup, 37% (95%CI: 20 to 56%) in the pathologic myopia subgroup, and 62% (95%CI: 14 to 100%) in the idiopathic MH subgroup. CONCLUSION Human amniotic membrane in the treatment of refractory MH results in visual improvement. It has a high macular hole closure rate and low dislocation/contracture rate. Cryopreserved hAM grafts might have better outcomes than dehydrated grafts.
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Affiliation(s)
- Hengdi Zhang
- Ophthalmology Department, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China.
| | - Y Li
- Department of Information, Medical Support Center, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
| | - G Chen
- Department of General surgery center, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
| | - F Han
- Ophthalmology Department, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
| | - W Jiang
- Ophthalmology Department, The General Hospital of Western Theater Command, PLA, 610083 Chengdu, Sichuan Province, P.R.China
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Applications of Human Amniotic Membrane Patching Assisted Vitrectomy in the Management of Postoperative PVR in Complex Retinal Detachments. J Clin Med 2023; 12:jcm12031137. [PMID: 36769785 PMCID: PMC9918292 DOI: 10.3390/jcm12031137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Human amniotic membranes (hAMs) are extraembryonic tissues currently employed in the treatment of many ocular and systemic diseases. Several reports indicate that hAMs can suppress the signaling pathway of tissue growth factor beta (TGF-β), a cytokine that plays a major role in the pathogenesis of proliferative vitreoretinopathy (PVR) through the induction of epithelial-mesenchymal transition (EMT) in exposed retinal pigmented epithelium (RPE) cells. The present study was conducted to evaluate the efficacy of a modified vitrectomy procedure (hAMP-V) involving the extensive coverage of exposed RPE with hAM patches to prevent postoperative PVR in a series of 15 cases of retinal detachment complicated by severe preoperatory PVR. The primary outcome was to assess the rate of successful retinal reattachment of a single hAMP-V procedure at 6 months from silicone oil removal. Secondary outcomes included the collection of intraoperative data concerning the quantity, size, and scope of hAM patches, and the assessment of postoperative improvements in mean LogMar BCVA at 3 and 6 months. Successful retinal reattachment was obtained in 14 out of 15 eyes (93.3%). Surgical failure due to major recurrence of PVR occurred in 1 out of 15 eyes (6.7%). Postoperative improvements in mean LogMar BCVA were statistically significant (p < 0.05, paired t-test). No intraoperative and postoperative adverse effects were reported. The study helped to refine the surgical technique while also offering cues for future improvements.
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Rezende FA, Ferreira BG, Rampakakis E, Steel DH, Koss MJ, Nawrocka ZA, Bacherini D, Rodrigues EB, Meyer CH, Caporossi T, Mahmoud TH, Rizzo S, Johnson MW, Duker JS. Surgical classification for large macular hole: based on different surgical techniques results: the CLOSE study group. Int J Retina Vitreous 2023; 9:4. [PMID: 36717928 PMCID: PMC9885593 DOI: 10.1186/s40942-022-00439-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/29/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The CLOSE study group proposes an updated surgical classification for large macular holes based on a systematic review of new treatments. Recently, many new techniques have been introduced to treat large full-thickness macular holes (FTMH); although the indications are not clear. An updated surgical classification is needed to help surgical decision-making. METHODS We gathered published series by the CLOSE Study Group members and from literature search until June 2021. Techniques included: internal limiting membrane peeling (ILM peeling), ILM flaps, macular hydrodissection (macular hydro), human amniotic membrane graft (hAM), and autologous retinal transplantation (ART). Within each technique, chi-square test assessed association between the minimal linear diameter (MLD) (in µm) and closure rate; the postoperative best-corrected visual acuity (BCVA) gains were compared among groups. RESULTS Data extraction included 31 published articles: total of 1135 eyes. Eyes were divided into the following groups: ILM peel (n: 683), ILM Flap (n: 233), macular hydrodissection (n: 64), hAM (n: 59), and ART (n: 96). The initial BCVA and size were heterogenous between the groups. ILM peel showed the best results in large FTMH ≤ 535 µm (closure rate 96.8%); adjusted mean BCVA: 0.49 (LogMAR) with a statistical difference among groups. Large FTMH between 535 and 799 µm: ILM flap technique showed better results (closure rate 99.0%); adjusted mean BCVA: 0.67(LogMAR); also with a statistical difference. For large FTMH ≥ 800 µm more invasive techniques are required. Use of hAM, macular hydrodissection and ART showed higher closure rates for this category (100%, 83.3% and 90.5% respectively), and adjusted mean BCVA varied from 0.76 to 0.89. Although there was no statistical difference between those techniques for this group due to the smaller number of cases. CONCLUSIONS The CLOSE study group demonstrated the potential usefulness of a new surgical classification for large FTMHs and propose OCT biomarkers for use in clinical practice and future research. This new classification demonstrated that Large (400-550 µm) and X-Large (550-800 µm) holes can be treated highly successfully with ILM peel and ILM flap techniques, respectively. Further studies are necessary for the larger FTMHs (XX-Large and Giant), using the CLOSE classification, in order to determine which technique is better suited for each hole size and characteristics.
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Affiliation(s)
- Flavio A. Rezende
- grid.14848.310000 0001 2292 3357Department of Ophthalmology, Maisonneuve-Rosemont Hospital, CIUSSS de l’est d’ile de Montréal, University of Montreal, 801 Rue de la Commune est, ap 501, Montreal, QC H2V0A3 Canada
| | - Bruna G. Ferreira
- grid.14848.310000 0001 2292 3357Department of Ophthalmology, Maisonneuve-Rosemont Hospital, CIUSSS de l’est d’ile de Montréal, University of Montreal, 801 Rue de la Commune est, ap 501, Montreal, QC H2V0A3 Canada
| | - Emmanouil Rampakakis
- grid.14709.3b0000 0004 1936 8649Faculty of Medicine and Health Sciences, McGill University, Montreal, QC Canada
| | - David H. Steel
- grid.1006.70000 0001 0462 7212Sunderland Eye Infirmary, Sunderland, and Newcastle University, Newcastle-Upon-Tyne, UK
| | - Michael J. Koss
- Augenzentrum Nymphenburger Höfe/Augenklinik Herzog Carl Theodor, Munich, Germany
| | | | - Daniela Bacherini
- grid.8404.80000 0004 1757 2304Department of Neurosciences, Psychology, Drug Research and Child Health, Eye Clinic, University of Florence, Florence, Italy
| | - Eduardo B. Rodrigues
- grid.262962.b0000 0004 1936 9342Department of Ophthalmology, St. Louis University, St. Louis, MO USA
| | | | - Tomaso Caporossi
- grid.8142.f0000 0001 0941 3192Fondazione Policlínico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy ,grid.418879.b0000 0004 1758 9800Instituto di Neuroscienze - CNR, Pisa, Italy
| | - Tamer H. Mahmoud
- grid.261277.70000 0001 2219 916XAssociated Retinal Consultants, Beaumont Neuroscience Center, Oakland University William Beaumont School of Medicine, Royal Oak, MI USA
| | - Stanislao Rizzo
- grid.8142.f0000 0001 0941 3192Fondazione Policlínico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy ,grid.418879.b0000 0004 1758 9800Instituto di Neuroscienze - CNR, Pisa, Italy
| | - Mark W. Johnson
- grid.214458.e0000000086837370Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI USA
| | - Jay S. Duker
- grid.67033.310000 0000 8934 4045New England Eye Center, Tufts Medical Center, Boston, MA USA ,grid.67033.310000 0000 8934 4045Department of Ophthalmology, Tufts Medical Center, Boston, MA USA
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Sharma R, Nappi V, Empeslidis T. The developments in amniotic membrane transplantation in glaucoma and vitreoretinal procedures. Int Ophthalmol 2023; 43:1771-1783. [PMID: 36715957 PMCID: PMC10149474 DOI: 10.1007/s10792-022-02570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 11/12/2022] [Indexed: 01/31/2023]
Abstract
The main reasons why Amniotic Membrane (AM) is transplanted in Ophthalmology are: to provide a substrate for cellular growth and to provide tectonic support or as a biological bandage and barrier that protects the wound to facilitate an environment for wound healing. The application of AM is well-documented in corneal disorders of various aetiologies [1], however, research within the field has highlighted how it can be used in conjunctival disorders and most recently, in glaucoma and vitreoretinal procedures. This review explores the preservation modalities of AM and summarises the current literature regarding AM transplantation in Glaucoma and Vitreoretinal conditions. AM transplantation in conjunction with trabeculectomy was reported to be used in two different surgical techniques. They differ in relation to the position of the implant: below the scleral flap or over the entire exposed sclera. The results of these studies suggest that AM transplant is a safe procedure that helps in the improvement of the intraocular pressure when associated with trabeculectomies. Moreover, it enhances trabeculectomies success rates when used along with mitomycin C [2]. The use of AM is also described for managing leaking blebs. It is mentioned to be a suitable alternative to conjunctival advancement. Regarding AM transplantation in glaucoma shunt or valve surgeries, the current literature is relatively limited. However, AM has been described as a good tectonic support for shunt procedures [3]. Successful results are described in the literature for surgical treatments using AM plug for vitreoretinal procedures. In particular macular hole closure and rhegmatogenous retinal detachment. In conclusion, AM transplant is a very promising and versatile adjutant therapy. However, further studies are also required for a better understanding and refinement of surgical techniques.
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Affiliation(s)
- Rohit Sharma
- Eye Department, University Hospitals Derby & Burton NHS trust, Burton, UK. .,School of Medicine, University of Nottingham, Nottingham, UK.
| | - Vivian Nappi
- Ophthalmology Department, Nottingham University Hospital NHS Trust, Nottingham, UK
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The use of biological amniotic membranes in the treatment of recurrent macular holes. Sci Rep 2022; 12:18661. [PMID: 36333334 PMCID: PMC9636383 DOI: 10.1038/s41598-022-21754-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
To evaluate the clinical therapeutic effects of a technique in which biological amniotic membranes (bAMs) are used in the treatment of patients with recurrent macular holes. In this prospective nonrandomized case series study, 23 eyes of 23 patients with recurrent macular holes who had already undergone surgery with pars plana vitrectomy with internal limiting membrane peeling were evaluated. In the surgery, a bAM was used to cover the macular area, and C3F8 tamponade was performed on these patients. Phacoemulsification combined with intraocular lens implantation was performed simultaneously in patients who had cataracts. Patients were followed up for at least half a year. The main outcomes were whether the macular hole closed, the morphological changes in the macular graft, the best-corrected visual acuity, intraocular pressure (IOP) and other indicators. In all eyes, the recurrent macular holes were closed. Two cases (8.69%, 2/23) had bAM shifting half a month after surgery, and these patients underwent a second surgery to adjust the position of the bAM and perform C3F8 tamponade. In the 6-month follow-up, 21 patients (91.30%, 21/23) had improved visual acuity (VA), and 2 patients (8.69%, 2/23) had no change in VA. The mean VA increased from 1.73 ± 0.32 before surgery to 1.12 ± 0.42 after surgery (t = 10.63, P = 0.00 < 0.01), and the mean IOP decreased from 22.13 ± 5.56 before surgery to 17.23 ± 1.71 after surgery (t = 5.14, P = 0.00 < 0.01). No serious complications occurred in any of the cases. The technique of using a biological amniotic membrane can be an effective treatment for patients with recurrent macular holes.
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13
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Surgical Techniques for Refractory Macular Holes. Int Ophthalmol Clin 2022; 62:103-117. [PMID: 35752889 DOI: 10.1097/iio.0000000000000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Pacini B, Bacherini D, Savastano A, Rizzo S, Caporossi T. Comparative analysis of macular microstructure in eyes treated with human amniotic membrane plug or internal limiting membrane transplant for Failed Macular Hole. Acta Ophthalmol 2022; 100:e1031-e1035. [PMID: 34562301 DOI: 10.1111/aos.15013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/21/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To document comparative analysis of macular microstructures of eyes treated with autologous internal limiting membrane (ILM) transplant and human Amniotic Membrane (hAM) plug transplant for failed macular holes (FMH). MATERIALS AND METHODS Six patients who underwent successful surgeries for FMH were evaluated. The first three patients had undergone autologous ILM transplant, the others had undergone hAM plug transplant. They were examined using Adaptive Optics (AO) at baseline and at 6 months after surgery; OCT and OCT-Angiography were performed at 6 months. All images were evaluated morphologically; AO images were also analysed using the internal software. RESULTS Regarding the AO analysis in ILM-patients, the average cone density inside the lesion was 7684.44 ± 362.96 and the total spacing was 10.86 ± 0.97. In hAM-patients, the average cone density inside the plug area was 10197.9 ± 326.62 and the total spacing was 10.6 ± 0.72. It was not possible to analyse cone density in the area outside the lesion on any patients. All patients were also evaluated morphologically. OCT analysis in ILM-patients showed a subverted anatomical situation, while in hAM-patients revealed the regrowth of tissue layers and a resumption of foveal depression. OCT-Angiography analysis revealed an enlargement of the FAZ in ILM-patients and a fairly normal appearance and size of the FAZ in hAM-patients, in comparison to the fellow eye. CONCLUSIONS Our findings require validation with a longer follow-up in a larger quantity of patients, but already suggest important differences in the cellular mechanism that underlies the tissue remodelling in these two techniques.
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Affiliation(s)
- Bianca Pacini
- Department of NEUROFARBA, Ophthalmology University of Florence Florence Italy
| | - Daniela Bacherini
- Department of NEUROFARBA, Ophthalmology University of Florence Florence Italy
| | - Alfonso Savastano
- Department of Ophthalmology Catholic University of Sacred‐Heart Foundation "Policlinico Universitario A. Gemelli" IRCCS Rome Italy
| | - Stanislao Rizzo
- Department of Ophthalmology Catholic University of Sacred‐Heart Foundation "Policlinico Universitario A. Gemelli" IRCCS Rome Italy
| | - Tomaso Caporossi
- Department of Ophthalmology Catholic University of Sacred‐Heart Foundation "Policlinico Universitario A. Gemelli" IRCCS Rome Italy
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Caporossi T, Carlà MM, Gambini G, De Vico U, Baldascino A, Rizzo S. Spotlight on the Internal Limiting Membrane Technique for Macular Holes: Current Perspectives. Clin Ophthalmol 2022; 16:1069-1084. [PMID: 35418741 PMCID: PMC8995173 DOI: 10.2147/opth.s284620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Pars plana vitrectomy has become the standard procedure for primary macular holes (MHs) repair, including the removal of the posterior cortical vitreous, the stripping of eventual epiretinal membranes, and finally an intraocular gas tamponade. During this procedure, peeling the internal limiting membrane (ILM) has been proven to increase closure rates and avoid postoperative reopening in several researches. In fact, even in large MHs more than 400 µm, the advantage of peeling off the ILM was highlighted by better anatomical closure rates. Nevertheless, some authors suggested that ILM peeling is not always essential, because it generates various side effects in retinal structure and function. Furthermore, the ideal amount of ILM peeling and the most effective strategies for removing the ILM are still subject of research. Different surgical modifications have been reported as alternatives to traditional peeling in certain clinical settings, including ILM flaps, ILM scraping, and foveal sparing ILM peeling. As regards large MHs, the introduction of ILM inverted flap appeared as a game changer, offering a significantly higher >90% closure rate when compared to traditional ILM peeling. Modifications to inverted ILM flap procedures have been claimed in recent years, in order to define the best area and direction of ILM peeling and its correlation with functional outcomes. Moreover, several innovations saw the light in the setting of recurrent MHs, such as ILM free flap transposition, inverted ILM flap combined autologous blood clot technique, neurosensory retinal flap, and human amniotic membrane (HAM) plug, claiming higher anatomical success rate also in those complex settings. In conclusion, the aim of this review is to report how the success rate of contemporary macular surgery has grown since the turn of the century, especially for big and chronic MHs, analyzing in which way ILM management became a crucial point of this kind of surgery.
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Affiliation(s)
- Tomaso Caporossi
- Ophthalmology Department, “Fondazione Policlinico Universitario A. Gemelli, IRCCS”, Rome, 00168, Italy
- Ophthalmology Department, Catholic University “Sacro Cuore”, Rome, Italy
| | - Matteo Mario Carlà
- Ophthalmology Department, “Fondazione Policlinico Universitario A. Gemelli, IRCCS”, Rome, 00168, Italy
- Ophthalmology Department, Catholic University “Sacro Cuore”, Rome, Italy
| | - Gloria Gambini
- Ophthalmology Department, “Fondazione Policlinico Universitario A. Gemelli, IRCCS”, Rome, 00168, Italy
- Ophthalmology Department, Catholic University “Sacro Cuore”, Rome, Italy
| | - Umberto De Vico
- Ophthalmology Department, “Fondazione Policlinico Universitario A. Gemelli, IRCCS”, Rome, 00168, Italy
- Ophthalmology Department, Catholic University “Sacro Cuore”, Rome, Italy
| | - Antonio Baldascino
- Ophthalmology Department, “Fondazione Policlinico Universitario A. Gemelli, IRCCS”, Rome, 00168, Italy
- Ophthalmology Department, Catholic University “Sacro Cuore”, Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Department, “Fondazione Policlinico Universitario A. Gemelli, IRCCS”, Rome, 00168, Italy
- Ophthalmology Department, Catholic University “Sacro Cuore”, Rome, Italy
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Xu C, Feng C, Han M, He J, Zhang R, Yan T, Li X, Liu Y, Li Y, Wu J. Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length ≥ 30 mm. Sci Rep 2022; 12:4258. [PMID: 35277581 PMCID: PMC8917174 DOI: 10.1038/s41598-022-08277-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/03/2022] [Indexed: 11/25/2022] Open
Abstract
To compare the efficacy of internal limiting membrane (ILM) flap covering to that of ILM flap insertion for the treatment of macular hole retinal detachment (MHRD) in highly myopic eyes with axial length (AL) ≥ 30 mm. We retrospectively analysed the medical records of 48 MHRD patients with high myopia (AL ≥ 30 mm). According to different surgical methods, the patients were divided into a covering group (23 eyes) and an insertion group (25 eyes). The rate of retinal reattachment and MH closure were compared between the two groups, and the related factors affecting the initial anatomical results were analysed. After primary vitrectomy and single silicone oil removal, there were 18 eyes (78.3%) in the covering group, and 20 eyes (80.0%) in the insertion group had retinal reattachment (P = 1.000). Moreover, 16 eyes (69.6%) in the covering group and 17 eyes (68.0%) in the insertion group had their MHs sealed (P = 0.907). The best-corrected visual acuity (BCVA) at 12 months and the improvement in BCVA postoperatively in the two groups were not statistically significant (P = 0.543, 0.955). Logistic regression analysis showed that elongated AL (OR = 1.844, 95% CI 1.037–3.280, P = 0.037) and higher choroidal atrophy (OR = 2.986, 95% CI 1.011–8.821, P = 0.048) were risk factors affecting initial anatomical success. For extremely high-myopia MHRD with AL ≥ 30 mm, ILM flap covering and insertion can both effectively seal the MH and promote retinal reattachment, but the visual function improvement may still be limited. The longer the AL and the higher the choroidal atrophy, the greater is the risk of initial anatomical failure.
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Affiliation(s)
- Changzhong Xu
- Department of Ophthalmology, The Second Xiangya Hospital, School of Ophthalmology, Central South University, Changsha, China
| | - Chao Feng
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Mengyao Han
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Junwen He
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Rui Zhang
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Tao Yan
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Xiangyun Li
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Yong Liu
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Yanzi Li
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China
| | - Jianhua Wu
- Aier Eye Hospital of Wuhan University, No. 481 Zhongshan Road, Wuchang District, Wuhan, China.
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Garcin T, Gain P, Thuret G. Epiretinal large disc of blue-stained lyophilized amniotic membrane to treat complex macular holes: a 1-year follow-up. Acta Ophthalmol 2022; 100:e598-e608. [PMID: 33998147 DOI: 10.1111/aos.14909] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/11/2021] [Accepted: 04/22/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE To report the long-term outcomes of large diameter epiretinal lyophilized amniotic membranes (lAMs) in recurrent or persistent macular holes (MHs) with or without rhegmatogenous retinal detachment (RRD), in a prospective interventional case series. METHODS Ten eyes of 10 patients underwent pars plana vitrectomy for MH-associated RRD (n = 5) or persistent MH without RRD (n = 5), in a university Hospital. A 3 or 4 mm diameter disc of lAM, stained with 0.06% trypan blue, was inserted with a catheter through a sclerotomy and positioned over the MH. Gas or silicone-oil tamponade was used. At 1 year, the main outcome was anatomic success defined as complete MH closure. Secondary outcomes were best corrected visual acuity (BCVA) recovery, changes in ellipsoid zone (EZ) and external limiting membrane (ELM) defects, complications. Mean follow-up was 13.8 ± 2.9 months (range, 12-18). RESULTS Mean baseline data were minimum and maximum diameters, respectively, 945 ± 330 and 1507 ± 717 μm; axial length 26.58 ± 3.38 mm; and number of prior surgeries 1.4 ± 0.96. At 1 year, anatomic success was achieved in eight eyes (80%), and two had reduced diameter of MH. All RRDs were reattached without recurrence. Mean logMAR BCVA improved from 1.92 ± 0.58 to 1.17 ± 0.57 (p < 0.001), with nine eyes (90%) achieving ≥0.3 logMAR improvement. Mean EZ and ELM defects decreased (p = 0.004, p = 0.003, respectively). Postoperative complications were RRD (n = 1) reattached by subsequent surgery, lAM slightly retracted under silicone (n = 1), foveal atrophy after early lAM displacement (n = 1). CONCLUSION A 1-year follow-up highlighted that epiretinal large discs of blue-stained lAM can help safely close refractory MHs, and provide satisfactory visual recovery.
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Affiliation(s)
- Thibaud Garcin
- Corneal Graft Biology, Engineering and Imaging Laboratory BiiGC EA2521 Federative Institute of Research in Sciences and Health Engineering Faculty of Medicine Jean Monnet University Saint‐Etienne France
- Ophthalmology Department University Hospital Saint‐Etienne France
| | - Philippe Gain
- Corneal Graft Biology, Engineering and Imaging Laboratory BiiGC EA2521 Federative Institute of Research in Sciences and Health Engineering Faculty of Medicine Jean Monnet University Saint‐Etienne France
- Ophthalmology Department University Hospital Saint‐Etienne France
| | - Gilles Thuret
- Corneal Graft Biology, Engineering and Imaging Laboratory BiiGC EA2521 Federative Institute of Research in Sciences and Health Engineering Faculty of Medicine Jean Monnet University Saint‐Etienne France
- Ophthalmology Department University Hospital Saint‐Etienne France
- Institut Universitaire de France Boulevard Saint‐Michel Paris France
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18
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Letter to the Editor Regarding "Surgical Management of Recurrent and Persistent Macular Holes: A Practical Approach". Ophthalmol Ther 2022; 11:919-922. [PMID: 35212941 PMCID: PMC8927488 DOI: 10.1007/s40123-022-00485-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/08/2022] [Indexed: 12/02/2022] Open
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19
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Romano MR, Rossi T, Borgia A, Catania F, Sorrentino T, Ferrara M. Management of refractory and recurrent macular holes: A comprehensive review. Surv Ophthalmol 2022; 67:908-931. [DOI: 10.1016/j.survophthal.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
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20
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Abdul-Kadir MA, Lim LT. Update on surgical management of complex macular holes: a review. Int J Retina Vitreous 2021; 7:75. [PMID: 34930488 PMCID: PMC8686572 DOI: 10.1186/s40942-021-00350-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 12/05/2021] [Indexed: 11/18/2022] Open
Abstract
Modern surgical interventions effectively treat macular holes (MHs) more than 90%. Current surgical treatment for MHs is pars plana vitrectomy with epiretinal membrane, internal limiting membrane (ILM) peeling, gas endotamponade, and prone posturing postoperatively. However, a small subset of MHs imposes challenges to surgeons and frustrations on patients. A narrative review was performed on the surgical treatment of challenging MHs including large and extra-large MHs, myopic MHs with or without retinal detachment, and chronic and refractory MHs. There are robust data supporting inverted ILM flap as the first-line treatment for large idiopathic MHs and certain secondary MHs including myopic MHs. In addition, several studies had shown that ILM flap manipulations in combination with surgical adjuncts increase surgical success, especially in difficult MHs. Even in eyes with limited ILM, surgical options included autologous retinal graft, human amniotic membrane, and creation of a distal ILM flap that can assist in MH closure even though the functional outcome may be affected by the MH chronicity. Despite relative success anatomically and visually after each technique, most techniques require a long-term study to analyze their safety profile and to establish any morphological changes of the MH plug in the closed MHs.
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Affiliation(s)
| | - Lik Thai Lim
- Department of Ophthalmology, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Malaysia
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21
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Yuan A, Yang D, Olmos de Koo L. Current Trends in Macular Hole Repair. CURRENT SURGERY REPORTS 2021. [DOI: 10.1007/s40137-021-00305-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Caporossi T, Governatori L, Verdina T, Rizzo S. Human amniotic membrane for failed macular hole. A case of initial unsuccessful outcome that resolved after amniotic membrane exchange. Eur J Ophthalmol 2021; 32:11206721211058996. [PMID: 34779681 DOI: 10.1177/11206721211058996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION We described a case of initial unsuccessful outcome of failed macular hole treated with amniotic membrane, that resolved after amniotic membrane exchange and silicone oil injection. CASE DESCRIPTION a woman affected by a high myopic macular hole that had failed to close after multiple surgeries, had been treated using an amniotic membrane graft and 20% sulfur hexafluoride but, after the gas reabsorption, the macular hole was still open, and the amnioticmembrane. A second surgery with a second amniotic membrane patch and silicone oil was carried out. Two weeks after the procedure the macular hole closed, and the final visual acuity improved from 20/400 to 20/100. CONCLUSIONS In this case, a second surgery, using a new amniotic membrane graft and a longer-lasting endotamponade, closed the hole and improved the visual acuity.
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Affiliation(s)
- Tomaso Caporossi
- Department of Ophthalmology, 96983Catholic University of Sacred-Heart Foundation "Policlinico Universitario A. Gemelli" IRCCS, Rome, Italy
| | - Lorenzo Governatori
- Department of Neurofarba, Ophthalmology, 9300University of Florence, Florence, Italy
| | - Tommaso Verdina
- Institute of Ophthalmology, 9306University of Modena and Reggio Emilia, Modena, Italy
| | - Stanislao Rizzo
- Department of Ophthalmology, 96983Catholic University of Sacred-Heart Foundation "Policlinico Universitario A. Gemelli" IRCCS, Rome, Italy
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Yan F, Wang C, Wilson JA, O'Connell M, Ton S, Davidson N, Sibichan M, Chambers K, Ahmed A, Summers J, Tang Q. Visually guided chick ocular length and structural thickness variations assessed by swept-source optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2021; 12:6864-6881. [PMID: 34858685 PMCID: PMC8606122 DOI: 10.1364/boe.433333] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/09/2021] [Accepted: 10/02/2021] [Indexed: 05/09/2023]
Abstract
Chicks are an excellent model for studying myopia. To study the change of the ocular structures in chicks, ultrasound is mostly used. However, it suffers from limited spatial resolution. In this study, we investigated the axial length (AL) and the thickness of different ocular structures in chicks' eye undergoing visually induced changes using a swept-source optical coherence tomography (SS-OCT) system in vivo. Two groups of chicks wore a translucent plastic goggle (n = 6) over the right eye to induce form-deprivation myopia. Following 12 days of form deprivation, goggles were removed in one group of chicks (n = 3), and they were allowed to experience 5 days of unrestricted vision (recovery). Goggles remained in place for a total of 17 days for the remaining 3 chicks. A separate group of 3 chicks were untreated and served as normal control. Ocular dimensions were measured in control, myopic, and recovered eyes using an SS-OCT system. We found myopic chick eyes had significantly thicker AL, lens thickness (LT), anterior chamber depth (ACD), and vitreous chamber depth (VCD), but significantly thinner retina thickness (RT) and choroid thickness (ChT) compared to the control eyes. Following 5 days of recovery, the cornea thickness (CT), retina pigment epithelium thickness (RPET), and ChT were significantly thicker, while the ACD and LT became significantly thinner compared to that of myopic eyes. SS-OCT can serve as a promising tool to provide measurements of the entire ocular structures, for evaluating the change of thickness and depth of different ocular structures in chicks in vivo. The change of AL in the myopic and recovered chick eyes can be attributed to the thickness alterations of different ocular structures. Altogether, this work demonstrated the feasibility of SS-OCT in chick myopic research and exhibited new insights into the changes of ocular structures in chicks experiencing myopia after unrestricted vision recovery.
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Affiliation(s)
- Feng Yan
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
- Equal contribution
| | - Chen Wang
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
- Equal contribution
| | - Jayla A Wilson
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
| | - Michael O'Connell
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
| | - Sam Ton
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
| | - Noah Davidson
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
| | - Mourren Sibichan
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
| | - Kari Chambers
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
| | - Ahmed Ahmed
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
| | - Jody Summers
- Department of cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City. OK 73126, USA
| | - Qinggong Tang
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73072, USA
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Ye J, Wu Y, Zhu S, Dong L, Qu J, Lu F, Xue A. EVALUATION OF THE EFFICACY OF POSTERIOR SCLERAL CONTRACTION IN THE TREATMENT OF MACULAR HOLE WITH RETINAL DETACHMENT IN HIGH MYOPIA. Retina 2021; 41:1874-1882. [PMID: 33492081 DOI: 10.1097/iae.0000000000003126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate efficacy of posterior scleral contraction for macular hole with retinal detachment in high myopia. METHODS Seventy-three macular hole with retinal detachment eyes were treated with posterior scleral contraction. A strip was sent across inferior-temporal scleral surface to posterior pole, then two ends were led out from nasal-inferior to temporal-superior areas. It was tightened to contract posterior sclera with designed axial length shortening ([10% of preoperative axial length-0.5] mm) after aqueous humor was drained from anterior chamber. Recovery was classified as type I (retinal reattachment with MH bridged) and II (retinal reattachment without MH bridged). Follow-up duration was 25.3 ± 18.0 months. RESULTS Axial length was 30.01 ± 2.27 mm at preoperation and shortened by 2.57 ± 0.82 mm intraoperatively. At final postoperation, maintained axial length shortening was 1.87 ± 0.92 mm. Forty-six eyes (63.0%) recovered as type I, 26 eyes (35.6%) as type II, and 1 eye (1.4%) unrecovered. Postoperative best-corrected visual acuity (logarithm of minimal angle of resolution) was better than preoperative one (0.85 ± 0.50 [Snellen 20/125] vs. 1.11 ± 0.56 [Snellen 20/250], P < 0.001) with correlation (r = 0.662, P < 0.001) and consistency (Kappa = 0.34, P < 0.001) between two. Best-corrected visual acuity improvement did not differ between recovery types (P = 0.206). CONCLUSION Macular hole with retinal detachment was successfully recovered by posterior scleral contraction with axial length shortening. Visual improvement was achieved, correlated, and consistent with preoperative best-corrected visual acuity while independent of recovery types.
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Affiliation(s)
- Jie Ye
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang, China
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Marlow ED, Mahmoud TH. Current management strategies for atypical macular holes. Taiwan J Ophthalmol 2021; 11:221-231. [PMID: 34703737 PMCID: PMC8493981 DOI: 10.4103/tjo.tjo_26_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/11/2020] [Indexed: 01/02/2023] Open
Abstract
This review evaluates the current surgical management options for refractory and atypical macular holes (MH) and proposes a treatment paradigm for approaching complex cases. A review of literature was performed to deliver a thorough discussion of the epidemiology and pathophysiology of MH as well as the historic evolution of surgical management strategies. With this context established, an update on recent surgical advances for management of large, chronic, and highly myopic MH is provided. New small MH may be adequately treated with pars plana vitrectomy, while those ≥300 μm should undergo internal limiting membrane (ILM) peel. For MH ≥400 μm with risk factors for failure, primary intervention should involve creation of an ILM flap and various methods of flap creation are discussed. For very large MH ≥700 μm or in refractory cases, autologous retinal transplants and other recently proposed procedures should be considered. While typical MHs enjoy high initial surgical success rates, atypical and refractory MH require additional intraoperative and postoperative considerations to maximize surgical success and optimize vision. With many techniques at the surgeon's disposal, patient selection becomes critical to improving outcomes.
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Affiliation(s)
| | - Tamer H. Mahmoud
- Associated Retinal Consultants, P.C., Royal Oak, MI, USA
- Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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26
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Mahmoud TH, Thompson JT. The Treatment of Difficult Macular Holes. Ophthalmol Retina 2021; 5:315-316. [PMID: 33814043 DOI: 10.1016/j.oret.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 10/21/2022]
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Chen YC, Chen SN. Human amniotic membrane grafts for retinal breaks in diabetic tractional retinal detachment and combined tractional and rhegmatogenous retinal detachment. Sci Rep 2021; 11:8035. [PMID: 33850166 PMCID: PMC8044097 DOI: 10.1038/s41598-021-86804-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/15/2021] [Indexed: 11/25/2022] Open
Abstract
To describe the surgical outcomes of using human amniotic membrane (hAM) grafts in the management of retinal breaks in diabetic tractional detachment (TRD) and combined tractional and rhegmatogenous retinal detachment (CTRRD). A retrospective case series of 10 eyes with TRD or CTRRD receiving pars plana vitrectomy with hAM grafts implantation, compared with 13 controls receiving the same surgery without hAM grafts. Best-corrected visual acuity (BCVA) and re-detachment rate were compared between two groups. Postoperatively, all eyes in the hAM group had retina attachment without recurrence, while 9 eyes in the control group had retina re-detachment and required additional surgery (0% vs 69.2%, p = 0.003). The BCVA significantly improved in the hAM group (from 1.96 ± 0.95 to 1.44 ± 0.77 in log MAR, p = 0.03), but not improved in control group (p = 0.20). Postoperative optical coherence tomography of the eyes receiving hAM grafts demonstrated glial tissue regeneration and restoration of ellipsoid zone. In diabetic TRD or CTRRD, hAM grafts could be an effective method, with promising outcome. Compared to standard surgery, it could result in higher retina reattachment rate and significant visual improvement. Moreover, it may offer the adjunctive benefit in tissue regeneration and fasten ellipsoid zone restoration.
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Affiliation(s)
- Yen-Chih Chen
- Department of Ophthalmology, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua City, Taiwan
- Department of Ophthalmology, Yunlin Christian Hospital, Xiluo, Taiwan
- Department of Optometry, Central Taiwan University of Science and Technology, Taichung City, Taiwan
| | - San-Ni Chen
- Department of Ophthalmology, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua City, Taiwan.
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Optometry, Da-Yeh University, Changhua, Taiwan.
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Chatziralli I, Machairoudia G, Kazantzis D, Theodossiadis G, Theodossiadis P. Inverted internal limiting membrane flap technique for myopic macular hole: A meta-analysis. Surv Ophthalmol 2021; 66:771-780. [PMID: 33652002 DOI: 10.1016/j.survophthal.2021.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/15/2021] [Accepted: 02/23/2021] [Indexed: 11/30/2022]
Abstract
A macular hole (MH) may be a significant complication in patients with high myopia. The recently reported inverted internal limiting membrane (ILM) flap technique is a promising alternative to treat myopic MHs. We performed a meta-analysis of the published anatomical and functional results of the "inverted ILM flap" technique for the treatment of myopic MH with or without retinal detachment (RD). Our results showed that the inverted ILM flap technique, either covering or insertion, is an effective method for treating myopic MH with or without RD and provides high MH closure, ranging from 91.8% to 97.1%. Despite the high MH closure rate, the pooled visual acuity improvement rate was 77.3% and 66.2% in patients with myopic MH without RD, while it was 95% and 80.3% in patients with myopic MHRD, using "covering" and "insertion" ILM flap technique, respectively. Potential complications included reopening or persistence of MH, development of RD, choroidal detachment, ocular hypertension, and chorioretinal atrophy.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistian University of Athens, Athens, Greece.
| | - Genovefa Machairoudia
- 2nd Department of Ophthalmology, National and Kapodistian University of Athens, Athens, Greece
| | - Dimitrios Kazantzis
- 2nd Department of Ophthalmology, National and Kapodistian University of Athens, Athens, Greece
| | - George Theodossiadis
- 2nd Department of Ophthalmology, National and Kapodistian University of Athens, Athens, Greece
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MANAGEMENT OF LARGE OR RECURRENT MACULAR HOLES. CURRENT OPHTHALMOLOGY REPORTS 2021; 8:62-68. [PMID: 33585076 DOI: 10.1007/s40135-020-00231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose of Review To review and critically appraise the recent literature about new surgical techniques for the management of large or recurrent macular holes. Recent Findings A variety of surgical approaches have recently been developed ranging from autologous retinal grafts to amniotic membrane transplant with varying levels of anatomical and visual success. Summary More data is needed to determine if one technique is superior to others. However, with a variety of grafts, adhesives, and tamponades at their disposal, vitreoretinal surgeons have an extensive array of options to approach complex macular holes.
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30
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Autologous Retinal Transplantation for Primary and Refractory Macular Holes and Macular Hole Retinal Detachments: The Global Consortium. Ophthalmology 2020; 128:672-685. [PMID: 33045315 DOI: 10.1016/j.ophtha.2020.10.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To report the anatomic and functional outcomes of autologous retinal transplantation (ART). DESIGN Multicenter, retrospective, interventional, consecutive case series. PARTICIPANTS One hundred thirty eyes of 130 patients undergoing ART for the repair of primary and refractory macular holes (MHs), as well as combined MH-rhegmatogenous retinal detachment (MH-RRD), between January 2017 and December 2019. METHODS All patients underwent pars plana vitrectomy and ART, with surgeon modification of intraoperative variables. A large array of preoperative, intraoperative, and postoperative data was collected. Two masked reviewers graded OCT images. Multivariate statistical analysis and subgroup analysis were performed. MAIN OUTCOME MEASURES Macular hole closure rate, visual acuity (VA), external limiting membrane and ellipsoid zone (EZ) band integrity, and alignment of neurosensory layers (ANL) on OCT. RESULTS One hundred thirty ART surgeries were performed by 33 vitreoretinal surgeons worldwide. Patient demographics were: mean age of 63 ± 6.3 years, 58% female, 41% White, 23% Black, 19% Asian, and 17% Latino. Preoperative VA was 1.37 ± 0.12 logarithm of the minimum angle of resolution (logMAR; Snellen equivalent, approximately 20/500), which improved significantly to 1.05 ± 0.09 logMAR (Snellen equivalent, approximately 20/225; P < 0.001) after surgery (mean follow-up, 8.6 ± 0.8 months). Autologous retinal transplantation was performed for primary MH repair in 27% of patients (n = 35), for refractory MH in 58% of patients (n = 76; mean number of previous surgeries, 1.6 ± 0.2), and for MH-RRD in 15% of patients (n = 19). Mean maximum MH diameter was 1470 ± 160 μm, mean minimum diameter was 840 ± 94 μm, and mean axial length was 24.6 ± 3.2 mm. Overall, 89% of MHs closed (78.5% complete; 10% small eccentric defect), with a 95% closure rate in MH-RRD (68.4% complete; 26.3% small eccentric defect). Visual acuity improved by at least 3 lines in 43% of eyes and by at least 5 lines in 29% of eyes. Reconstitution of the EZ (P = 0.02) and ANL (P = 0.01) on OCT were associated with better final VA. Five cases of ART graft dislocation (3.8%), 5 cases of postoperative retinal detachment (3.8%), and 1 case of endophthalmitis (0.77%) occurred. CONCLUSIONS In this global experience, patients undergoing ART for large primary and refractory MHs and MH-RRDs achieved good anatomic and functional outcomes, with low complication rates despite complex surgical pathologic features.
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Figueroa MS, Mora Cantallops A, Virgili G, Govetto A. Long-term results of autologous plasma as adjuvant to pars plana vitrectomy in the treatment of high myopic full-thickness macular holes. Eur J Ophthalmol 2020; 31:2612-2620. [DOI: 10.1177/1120672120960340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: To analyse the feasibility and efficacy of a novel autologous plasma rich in growth factor (PRGF) preparation as adjuvant to pars plana vitrectomy and internal limiting membrane peel in high myopic full-thickness macular hole (FTMH). Methods: Single-centre, single-surgeon retrospective chart review of consecutive patients with high myopic FTMH who underwent surgery with a minimum follow-up of 12 months. Patients were divided in group 1 (naïve) and group 2 (persistent). Quantitative and qualitative variables were analysed, compared among groups and correlated with best corrected visual acuity (BCVA). Results: Postoperatively, FTMH resolved in 28/31 eyes in group 1 (90%) and in 10/11 eyes in group 2 (91%), without significant differences ( p = 0.954). None of the preoperative anatomical variables analysed showed significant association with preoperative BCVA. Intraoperatively, no significant complications were registered. Postoperatively, BCVA improved significantly in the studied population ( p < 0.001). Preoperative factors associated with better postoperative BCVA were the presence of intraretinal cystoid spaces ( p = 0.028) and elevated FTMH borders ( p = 0.005). Preoperative dome-shaped macula was associated with significantly worse postoperative BCVA ( p = 0.049). Conclusion: The use of PRGF as adjuvant to vitrectomy showed to be reproducible, straightforward and efficient, with primary anatomical success rate comparable to other surgical approaches and lower risk of complications.
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Affiliation(s)
- Marta S Figueroa
- Retina Division, Ophthalmology Department, Ramon y Cajal University Hospital, Madrid, Spain
- Alcala University, Madrid, Spain
- Vissum, Madrid, Spain
| | - Arnau Mora Cantallops
- Retina Division, Ophthalmology Department, Ramon y Cajal University Hospital, Madrid, Spain
| | - Gianni Virgili
- Ophthalmology Department, Careggi University Hospital, University of Florence, Firenze, Italy
| | - Andrea Govetto
- Ophthalmology Department, Fatebenefratelli-Oftalmico Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
- Vitreoretinal Division, Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Ittarat M, Somkijrungroj T, Chansangpetch S, Pongsachareonnont P. Literature Review of Surgical Treatment in Idiopathic Full-Thickness Macular Hole. Clin Ophthalmol 2020; 14:2171-2183. [PMID: 32801628 PMCID: PMC7398756 DOI: 10.2147/opth.s262877] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To summarize current surgical techniques for treating primary macular holes (MHs). Methods We reviewed publications detailing surgical approaches to primary MHs, briefly described their protocols, and outlined their results. Results Currently, the technique for primary MH repair is pars plana vitrectomy, removing the posterior cortical vitreous, stripping the epiretinal membranes, and ending with intraocular gas tamponade. The evident benefit of peeling off the internal limiting membrane (ILM) was clearly shown for MHs at stages 2 to 4 by achieving an anatomical closure rate of >90%, even in large MH up to 650 µm. Newer MH surgical techniques include modification of ILM flap techniques, placing an autologous scaffolding of tissue within the hole, and cell therapy has shown to increase the closure rate of large and chronic macular holes, resulting in modest functional improvement in complicated MHs. Conclusion Since the turn of the century, the success rate of modern macular surgery has increased, even for large and chronic MHs. There seems to be no limit to novel concepts in MH surgery, which range from anatomical closure to those proposing natural restoration of visual function via stem cell therapy.
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Affiliation(s)
- Mantapond Ittarat
- Surin Hospital and Surin Medical Education Center, Department of Ophthalmology, Suranaree University of Technology, Surin, Thailand.,Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Thanapong Somkijrungroj
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Vitreoretinal Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sunee Chansangpetch
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Glaucoma Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pear Pongsachareonnont
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Vitreoretinal Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Walkden A. Amniotic Membrane Transplantation in Ophthalmology: An Updated Perspective. Clin Ophthalmol 2020; 14:2057-2072. [PMID: 32801614 PMCID: PMC7383023 DOI: 10.2147/opth.s208008] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/22/2020] [Indexed: 01/23/2023] Open
Abstract
Aim The aim of this paper is to provide a succinct literature review of the different clinical applications for AMT usage in an ophthalmic setting, ranging from commonly used applications to less mainstream approaches. The hope is that this review enables the reader to have a better understanding of the biological properties of amnion as well as the indications and scenarios in which AMT can be used, whilst presenting relevant evidence from within the literature which may be of interest. We also provide an update on the methods of preservation of amniotic membrane and the application methodologies. Methods Literature search. A PubMed search was performed using the search terms “amniotic membrane transplant”, “amnion AND cornea”, amnion AND ophthalmology”, “amnion AND ocular surface” and “Amnion AND eye”. A full review of the literature using the PubMed database was conducted up until 01/05/20. The articles used were written in English, with all articles accessed in full. Both review articles and original articles were used for this review. All full publications related to ophthalmology were considered.
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Affiliation(s)
- Andrew Walkden
- Manchester Royal Eye Hospital, Manchester University Foundation Trust, Manchester, UK.,University of Manchester Faculty of Medical and Human Sciences, Manchester, Greater Manchester, UK
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Long-term follow-up of primary silicone oil tamponade for retinal detachment secondary to macular hole in highly myopic eyes: a prognostic factor analysis. Eye (Lond) 2020; 35:625-631. [PMID: 32376975 DOI: 10.1038/s41433-020-0922-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate the risk factors associated with retinal detachment recurrence after first vitrectomy in high myopic eyes with macular hole retinal detachment (MHRD). METHODS Patients with high myopic eyes with MHRD who underwent pars plana vitrectomy and silicone oil (SO) tamponade with a follow-up period more than 12 months and more than 3 months after SO removal were included in this retrospective study. Logistic regression was performed to determine the risk factors associated with retinal re-detachment. RESULTS A total of 45 eyes from 43 patients were included in this study (11 male and 34 female patients). The retinal re-detachment rate after the first removal of silicon oil was 35.5% (16/45) in a mean postoperative follow-up time of 35.64 ± 32.94 months. Complete macular atrophy on fundus photography (odds ratio (OR) = 17.021, 95% confidence interval (95% CI): 2.218-130.609, p = 0.006) was a risk factor for MHRD after SO removal, while internal limiting membrane (ILM) peeling (OR = 0.091, 95% CI: 0.013-0.633, p = 0.015) and duration of SO tamponade (OR = 0.667, 95% CI: 0.454-0.980, p = 0.039) were protective factors. CONCLUSION For high myopic eyes with MHRD, complete macular atrophy was a significant risk factor for retinal re-detachment after silicon oil removal. ILM peeling and the duration of silicon oil tamponade were protective factors.
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35
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Caporossi T, Tartaro R, Giansanti F, Rizzo S. The amniotic membrane for retinal pathologies. Insights on the surgical techniques. Graefes Arch Clin Exp Ophthalmol 2020; 258:1347-1349. [DOI: 10.1007/s00417-020-04665-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022] Open
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