Autologous Retinal Transplantation for Primary and Refractory Macular Holes and Macular Hole Retinal Detachments

Moysidis, Stavros N.; Koulisis, Nicole; Adrean, Sean D.; Charles, Steve; Chetty, Naren; Chhablani, Jay; Cortes, Javier Cisneros; Embabi, Sherif N; Gordon, Carmelina; Gregori, Ninel Z.; Habib, Ahmed M.; Hamza, Hany S.; Hassaan, Hisham; Hassan, Tarek; Houghton, Odette M.; Kadonosono, Kazuaki; Kusaka, Shunji; Mantia, Alberto La; Lai, Chao‐Lun; Lumi, Xhevat; Maeno, Takatoshi; Mahgoub, Mohamed M; Baha, Samir Mohamed El; Morales-Cantón, Virgilio; Nowara, Mohamed; Okonkwo, Ogugua Ndubuisi; Parolini, Barbara; Rezende, Flávio; Rogalinska, Izabela; Rojas, Sergio; Steel, David; Stopa, Marcin; Wu, An Lun; Yamada, Keiko; Yamada, Mitsunori; Mahmoud, Tamer H.

doi:10.1016/j.ophtha.2020.10.007

Cited by 64 publications

(77 citation statements)

References 40 publications

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“…The standard treatment for full-thickness macular hole (FTMH) is pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peel and intravitreal gas tamponade, of which anatomic success rates were reported as high as 85–100% 1 – 3 . Surgical techniques have since been developed to improve the anatomic success rates of large macular holes, such as inverted ILM flap techniques and autologous retinal transplantation 4 , 5 . However, a sealed hole does not guarantee the great improvement in visual acuity with this high surgical success rate.…”

Section: Introductionmentioning

confidence: 99%

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

Lee

Kim

Song

et al. 2021

Sci Rep

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To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.

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Section: Introductionmentioning

confidence: 99%

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

Lee

Kim

Song

et al. 2021

Sci Rep

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“…Notably, around half of our patients showed BM defect preoperatively, which means the photoreceptor layer already occurred irreversible damage due to the extensive chorioretinal atrophy. In addition, the increase in visual acuity was partly due to retinal reattachment ( 19 ). It is interpretable that the postoperative BCVA of the two groups was similar.…”

Section: Discussionmentioning

confidence: 99%

“…With the disappearance of the HF, the ELM and EZ band gradually reconstituted. Therefore, these HF suggest the presence of microglia, playing a role in wound healing ( 19 ). Kaya et al guessed that HF are the deposition of ILM patches, glial cells and invaded RPE ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

The Role of Internal Limiting Membrane Flap for Highly Myopic Macular Hole Retinal Detachment: Improving the Closure Rate but Leading to Excessive Gliosis

Chen

Wang

et al. 2021

Front. Med.

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Purpose: To investigate the surgical outcomes of the inverted internal limiting membrane (ILM) flap technique for macular hole retinal detachment (MHRD) in high myopia.Methods: This was a retrospective interventional study on 45 highly myopic eyes with MHRD after ILM peeling (n = 24, peeling group) or the inverted ILM flap technique (n = 21, inverted group). The inverted group was consisted of autologous blood (AB) subgroup (n = 10) and perfluorocarbon liquid (PFCL) subgroup (n = 11). MH closure, best-corrected visual acuity (BCVA), foveal microstructures, and excessive gliosis were analyzed during a follow-up of over 12 months.Results: The inverted group achieved a higher MH closure rate (95.24%) than the peeling group (41.67%; p < 0.001). No significant difference was found in postoperative BCVA between the two groups (p = 0.98) or between the closed MH with or without excessive gliosis (p = 0.60). Excessive gliosis was identified in 9 eyes in the inverted group, and there was no difference in the incidence of excessive gliosis between the AB subgroup (4 in 10 eyes, 40%) and the PFCL subgroup (5 in 11 eyes, 45.45%) (p > 0.999).Conclusion: The inverted ILM flap technique was effective in MH closure but had no advantage in postoperative BCVA and microstructural restoration. Excessive gliosis was only detected in the inverted group but did not affect the postoperative BCVA. Additionally, the incidence of excessive gliosis was not affected by adjuvants.

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“…Recently the usefulness of an autologous retinal transplantation was reported in 130 eyes with refractory and large MHs. 5 For refractive MH which failed to be closed by an inverted ILM flap, the autologous retinal transplantation might be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap

Kawamata

Baba

Yokouchi

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose To report a case in which an internal limiting membrane (ILM) flap that was used to cover an idiopathic macular hole (MH) during pars plana vitrectomy (PPV) with the inverted internal limiting membrane flap technique partially detached from the retina. Most interestingly, the flap fell back spontaneously to re-cover the MH. Observations A 70-year-old woman presented with a full-thickness MH, and her vision was 20/400. She underwent PPV with an inverted ILM flap and air tamponade. When the intraocular gas was absorbed, the ILM flap detached but was held to the retina where it had not been peeled and the MH was open. Her visual acuity at this time was 20/400. The patient did not want further treatment and was followed by observation alone. At three months after the initial surgery, the ILM flap was noted to have spontaneously re-covered the MH, and her visual acuity improved to 20/200. At 6 months after the re-covering, the flap remained over the MH and the visual acuity remained at 20/200. Conclusions and Importance Surgeons should be aware that it is possible for an ILM flap created by the inverted ILM flap technique to partially detach from the retina after the tamponade gas is resorbed. Most importantly, the flap can return to re-cover the MH spontaneously.

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Autologous Retinal Transplantation for Primary and Refractory Macular Holes and Macular Hole Retinal Detachments

Cited by 64 publications

References 40 publications

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

The Role of Internal Limiting Membrane Flap for Highly Myopic Macular Hole Retinal Detachment: Improving the Closure Rate but Leading to Excessive Gliosis

Partial detachment of internal limiting membrane flap and spontaneous re-covering of macular hole by flap

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