Intraoperative and Postoperative Monitoring of Autologous Neurosensory Retinal Flap Transplantation for a Refractory Macular Hole Associated With High Myopia

Takeuchi, Jun; Kataoka, Keiko; Shimizu, Hideyuki; Tomita, Ryo; Kominami, Taro; Ushida, Hiroaki; Kaneko, Hiroki; Ito, Yasuki; Terasaki, Hiroko

doi:10.1097/iae.0000000000003000

Cited by 11 publications

(12 citation statements)

References 31 publications

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“…Graft displacement or retraction, new or recurrent retinal detachment, vitreous hemorrhage, choroidal neovascular membrane formation, endophthalmia, graft atrophy, graft edema, RPE hyperplasia or atrophy, subretinal perfluorocarbon droplets, and epiretinal membrane formation can be seen after surgeries involving autologous retinal grafting. 1,5,9,10,16,17 No such complication was encountered in our case.…”

Section: Discussionmentioning

confidence: 47%

“…6,7 Optical coherence tomography (OCT) can be used both during surgery to ensure proper graft placement and in postoperative followup to evaluate hole closure. 8,9,10 Although retinal autografts are mostly used in surgery for large and refractory macular holes in eyes with high myopia, they can also be used in the treatment of macular holes accompanied by retinal detachment. 5,8,11 In this study, we aimed to evaluate the anatomical and functional results and effectiveness of autologous retinal graft transplantation in a patient with large macular hole and retinal detachment.…”

Section: Introductionmentioning

confidence: 99%

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Logbook of a Retinal Autograft

Güven¹,

Gül²,

Yılmaz³

et al. 2022

tjo

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This study aimed to evaluate the prognosis of a retinal autograft that was used to treat a macular hole that occurred after repeated vitreoretinal surgeries. A patient underwent repeated vitreoretinal surgery due to retinal detachment in the right eye, and the internal limiting membrane was also removed during the surgeries. After silicone oil removal, the patient developed recurrent retinal detachment and macular hole, and for this reason a retinal autograft was applied to the macular hole and silicone tamponade was administered. The silicone oil was removed at postoperative 7 months, and the macular hole was observed to be closed on fundus examination at 18 months. The final visual acuity was 5/100. On optical coherence tomography (OCT), the hole in the detached retina was measured as 600 μm in diameter preoperatively, 1020 μm on the first postoperative day, gradually narrowed to 765 μm, and graft integration occurred. During follow-up, the accumulation of hyperreflective spots persisted on the inner surface of the graft tissue and in all vertically extending sections. In en face sections, it appeared as a hyperreflective arc between the graft and host retina with a shadowing artefact. In OCT angiography evaluation, a punctate multiple blood flow signal in the vertical axis of the graft was detected in the early phase at 3 months. This finding persisted at 1 month after silicone removal, and the flow signal disappeared with resorption of the cystic edema. These flow signals were in the same location as the areas of hyperreflective spots on structural OCT. In conclusion, structural OCT and OCT angiography are effective methods for the follow-up of retinal autograft integration into host tissue.

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Section: Discussionmentioning

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Logbook of a Retinal Autograft

Güven¹,

Gül²,

Yılmaz³

et al. 2022

tjo

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“…Preoperative BCVA was the only parameter that exhibited a correlation with the final visual acuity. Considering the subgroup analyses, the final BCVA was significantly lower in the ART group than in the other groups [ 2 , 25 ]. The smaller number of cases, larger minimum diameter, and significantly lower initial BCVA in the ART group (Table 3 ) does not allow us to further comment on the results of this technique.…”

Section: Discussionmentioning

confidence: 99%

A retrospective, multicenter study on the management of macular holes without residual internal limiting membrane: the refractory macular hole (ReMaHo) study

Lorenzi

Mehech

Caporossi

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate the surgical management, outcomes and prognostic factors of full thickness macular holes without residual internal limiting membrane (NO-ILM FTMHs). Methods We performed a multicenter, retrospective study of 116 NO-ILM FTMHs. Human amniotic membrane (hAM) plug, autologous ILM free flap transplantation (AILMT), and autologous retinal graft transplantation (ART) were performed in 58, 48, and 10 patients, respectively. Data were collected before and up to 12 months after surgery. The primary outcomes were hole closure and final best-corrected visual acuity (BCVA). Results The final BCVA (0.78 ± 0.51 logMAR) was significantly better than and correlated with the initial BCVA (p < 0.0001 and p = 0.004, respectively). Hole closure was achieved in 92% of eyes. The minimum FTMH diameter was wider and final BCVA was lower in the ART group than in the other groups (p < 0.003 and p < 0.001, respectively). FTMHs with diameter > 680 μm had a higher closure rate with hAM than with AILMT (p = 0.02). Conclusions AILMT and hAM were the most frequently performed surgeries with both high closure rate and significant functional improvement. Preoperative BCVA was correlated with final BCVA. The minimum FTMH diameter may guide the treatment choice.

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“…28 Infrequent postoperative complications include graft dislocation, postoperative proliferative vitreoretinopathy, postoperative retinal detachment, endophthalmitis, subfoveal RPE damage, choroidal neovascularization, and subretinal or vitreous hemorrhage. 28,29 Adjunct autologous blood clot or dispersive ophthalmic viscoelastic devices have been used to prevent graft dislocation but require further study. 10,30 Anatomic, Visual, and Functional Outcomes When analyzing ART series of at least five eyes, the weighted mean closure rate was 88% (range: 66.7%-100%) for a variety of MH repairs (Table 1).…”

Section: Surgical Techniquementioning

confidence: 99%

“…10,30 Anatomic, Visual, and Functional Outcomes When analyzing ART series of at least five eyes, the weighted mean closure rate was 88% (range: 66.7%-100%) for a variety of MH repairs (Table 1). 9,10,25,[28][29][30][31][32][33][34] Patients with larger MH diameters demonstrated lower rates of successful closure. 9,34 Cases without successful closure usually did not achieve graft integration into the surrounding tissue.…”

Section: Surgical Techniquementioning

confidence: 99%

Autologous Neurosensory Retinal Transplantation

Patel

Mahmoud

Kazahaya

et al. 2021

Retina

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Purpose: To review the autologous retinal transplantation surgical technique, indications, rationale, and current outcomes of data published to date.Methods: Review of surgical technique, preoperative and postoperative best-corrected visual acuity, and macular hole (MH) closure rate in studies with at least five eyes.Results: The weighted average macular hole closure rate is 88%, with a MH closure rate ranging from 66.7% to 100%. The weighted average best-corrected visual acuity improved from mean logarithm of the minimum angle of resolution 1.35 (Snellen equivalent of 20/450) preoperatively to mean logarithm of the minimum angle of resolution 1.02 (Snellen equivalent of 20/210) postoperatively. From the largest autologous retinal transplantation case series, 37% of patients gained 3 or more lines of visual acuity after autologous retinal transplantation for primary or refractory MHs and 74% gained 3 or more lines of visual acuity after autologous retinal transplantation for MH-retinal detachments. Functional improvement including negative Watzke-Allen sign and conversion from positive to negative scotoma was reported in large case series.Conclusion: Autologous retinal transplantation is a promising technique for closure of large and refractory MHs otherwise difficult to repair with conventional techniques. This technique may allow for replacement of neural tissue in the macula through cell rehabilitation and regeneration through presumed ectopic synaptogenesis, retinal progenitor cell differentiation and integration, and/or retinal progenitor cell material transfer to host neurons.

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Intraoperative and Postoperative Monitoring of Autologous Neurosensory Retinal Flap Transplantation for a Refractory Macular Hole Associated With High Myopia

Cited by 11 publications

References 31 publications

Logbook of a Retinal Autograft

Logbook of a Retinal Autograft

A retrospective, multicenter study on the management of macular holes without residual internal limiting membrane: the refractory macular hole (ReMaHo) study

Autologous Neurosensory Retinal Transplantation

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