Combined Internal Limiting Membrane Flap and Autologous Plasma Concentrate to Close a Large Traumatic Macular Hole in a Pediatric Patient

Finn, Arthur L.; Chen, Xi; Viehland, Christian; Izatt, Joseph A.; Toth, Cynthia A.; Vajzovic, Lejla

doi:10.1097/icb.0000000000000762

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…7,14,15 Many other techniques for macular hole closure have been described, including radial retinal incisions, autologous blood and platelet products, and inverted ILM flaps. [8][9][10] In our study, perimacular hole Tano brushing to oppose the edges of the macular hole in 1 child during the second operation resulted in successful anatomic closure. In another child, platelet-rich plasmin was used during the second vitrectomy, resulting in successful closure.…”

Section: Discussionmentioning

confidence: 52%

“…The present study is the largest series to our knowledge of pediatric macular holes operated on with microincisional surgery, and corroborates a high single (81%) and final (94%) success rate that others have reported (67% to 100%) in smaller series. 1,2,8,10,11,13 The study cohort was similar to other studies in regard to preoperative duration. 4,5 Surgical techniques varied based on each surgeon's preference, but ILM peeling and internal tamponade were mostly uniformly pursued, as has been advocated for idiopathic macular holes.…”

Section: Discussionmentioning

confidence: 64%

“…4 Owing to the relatively small number of pediatric patients with macular holes and even fewer requiring surgery, limited studies exist on the surgical outcomes after pediatric macular hole repair. 2,3,[5][6][7][8][9] To our knowledge, the present study is the largest case series of pediatric patients specifically undergoing microincisional surgery for repair of pediatric macular holes. 2,7,10,11 Methods A multicenter retrospective review of microincisional surgical cases of pediatric macular holes was performed.…”

Section: Introductionmentioning

confidence: 99%

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A Multicenter Study of Pediatric Macular Holes: Surgical Outcomes With Microincisional Vitrectomy Surgery

Kothari

Read

Baumal

et al. 2019

Journal of VitreoRetinal Diseases

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Purpose: Pediatric macular holes occur often related to trauma and rarely require surgical intervention. The purpose of the present study was to evaluate outcomes of microincisional vitrectomy surgery. Methods: A multicenter retrospective consecutive case series was conducted of pediatric patients undergoing surgery for macular hole repair. Results: A total of 31 eyes from 8 centers were included in this study. The mechanism of macular hole development was blunt trauma in 30 eyes (97%) and industrial laser in 1 eye (3%). The rate of anatomic closure after primary vitrectomy was 81% (25 eyes); the final anatomic closure rate after a secondary vitrectomy was 94% (29 eyes). There was a statistically significant improvement in visual acuity from initial presentation (20/164) to final follow-up (20/100) ( P = .009). Conclusions: Microincisional vitrectomy surgery for pediatric macular holes results in substantial anatomic success and modest improvement in visual acuity.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Multicenter Study of Pediatric Macular Holes: Surgical Outcomes With Microincisional Vitrectomy Surgery

Kothari

Read

Baumal

et al. 2019

Journal of VitreoRetinal Diseases

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“…Modifications such as the use of viscoelastic cap, perfluorocarbon liquid (PFCL), autologous blood clot, and cabbage-leaf technique have been proposed to prevent flap dislocation. [ 25 26 27 28 29 30 31 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of platelet-rich plasma and inverted internal limiting membrane flap for the management of large macular holes: A pilot study

Babu

Kohli

et al. 2020

Indian J Ophthalmol

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Purpose: To compare the safety and efficacy of 25-gauge pars plana vitrectomy (PPV) with either platelet-rich plasma (PRP) or inverted internal limiting membrane (ILM) flap for the treatment of large macular hole. Methods: Pseudophakic patients with idiopathic macular holes with a minimum diameter (MD) of 600–1500 μm were randomized into two groups (30 patients each): 25-gauge PPV with either inverted ILM flap (group A) or PRP (group B). Results: Mean MD in groups A and B were 803.33 ± 120.65 μm and 784.73 ± 120.10 μm, respectively ( P = 0.552). Mean base diameter in groups A and B was 1395.17 ± 240.57 μm and 1486.90 ± 281.61 μm, respectively ( P = 0.180). The median presenting best-corrected visual acuity (BCVA) was logMAR 0.78 (range 0.78–1.00) and logMAR 0.78 (Range 0.60–1.00) in groups A and B, respectively ( P = 0.103). Anatomical closure was achieved in 90% ( n = 27/30) and 93.3% ( n = 28/30) eyes in groups A and B, respectively ( P = 0.158). Type 1 closure was achieved in 76.7% ( n = 23/30) and 83.3% ( n = 25/30) eyes in groups A and B, respectively. Median BCVA at postoperative 3-month in groups A and B was logMAR 0.60 (range 0.48–0.60) and logMAR 0.60 (range 0.48–0.78), respectively ( P = 0.312). The average visual improvement was 2.0 and 2.5 early treatment diabetic retinopathy study (ETDRS) lines in groups A and B, respectively ( P = 0.339). None of the patients developed postoperative exaggerated inflammatory reactions. Conclusion: Using platelets for the treatment of large macular holes is as safe and effective as an inverted ILM flap.

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“… 88 Recently, it was described a case in which inverted ILM flap assisted by autologous plasma concentrate was successfully performed in a pediatric patient with traumatic large FTMH. 97 A comparative study showed a closure rate of 92% and 75%, and VA improvement of 5 lines and 2.5 lines after inverted ILM flap and ILM peeling, respectively. 98 The authors concluded that the inverted ILM flap technique provides a better outcome in traumatic FTMHs than ILM peeling.…”

Section: Surgical Outcomes Of Inverted Ilm Flap Techniquementioning

confidence: 97%

Inverted Internal Limiting Membrane Flap Technique: Is It the Best Option for Macular Holes?

Silva¹,

Ferreira²,

Michalewska³

et al. 2021

OPTH

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Surgical treatment is generally necessary to repair full-thickness macular holes (FTMH). Although vitrectomy with or without internal limiting membrane (ILM) peeling remains the standard surgical technique, the inverted ILM flap procedure has increasingly assumed a role in the primary surgical repair of FTMHs. Some vitreoretinal surgeons reserve this technique to treat large or myopic holes, whereas others use it routinely in all cases. This paper is a comprehensive review of the current scientific evidence on the anatomical and functional outcomes of the inverted ILM flap technique in the repair of macular holes, following the International Vitreomacular Traction Study (IVTS) group classification.

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Combined Internal Limiting Membrane Flap and Autologous Plasma Concentrate to Close a Large Traumatic Macular Hole in a Pediatric Patient

Abstract: Summary Statement The authors describe a surgical technique using autologous plasma concentrate with internal limiting membrane flap to successfully close a large, traumatic macular hole in a pediatric patient

Cited by 13 publications

References 16 publications

A Multicenter Study of Pediatric Macular Holes: Surgical Outcomes With Microincisional Vitrectomy Surgery

A Multicenter Study of Pediatric Macular Holes: Surgical Outcomes With Microincisional Vitrectomy Surgery

Comparison of platelet-rich plasma and inverted internal limiting membrane flap for the management of large macular holes: A pilot study

Inverted Internal Limiting Membrane Flap Technique: Is It the Best Option for Macular Holes?

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