Visual and anatomical success with short-term macular tamponade and autologous platelet concentrate

Mulhern, Mark G.; Cullinane, Anthony; Cleary, Philip E.

doi:10.1007/s004170000154

Cited by 36 publications

(24 citation statements)

References 31 publications

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“…Two comparative studies in the 1990s showed that the use of long-acting C 3 F 8 gas and prolonged prone positioning (for more than 2 weeks) provided a better improvement in visual acuity and a higher rate of MH closure [12,13]. However, later trials found that a short tamponade by short-acting gases and shorter face-down posturing (for up to 10 days) provided anatomical and visual outcomes comparable to those associated with a longer tamponade [5,14,15,16]. Moreover, two recent multicentre randomised controlled trials (RCTs) suggested that no face-down posturing was necessary for small MHs (<400 μm) [15,16].…”

Section: Mh Surgerymentioning

confidence: 99%

Predicting Visual Outcome following Surgery for Idiopathic Macular Holes

Kusuhara

Negi

2013

Ophthalmologica

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Since Kelly and Wendel [Arch Ophthalmol 1991;109:654-659] first reported successfully treating macular holes (MHs) using pars plana vitrectomy in 1991, MH surgery has been constantly improved. For example, introducing the removal of the internal limiting membrane considerably increased the closure rate of MHs, and the advent of microincision vitrectomy surgery reduced surgical trauma and decreased patient discomfort after surgery. As modern MH surgery can achieve a higher anatomical success rate and alleviate patients' postoperative distress, postoperative visual outcomes have lately become the primary concern. Informing patients of the expected visual acuity and visual improvement before surgery is ideal, but predicting postoperative visual outcomes is difficult because a large number of factors are associated with them. In this paper, we review previous studies and provide accumulating evidence for the relationship between individual prognostic factors and visual outcomes after MH surgery.

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Section: Mh Surgerymentioning

confidence: 99%

Predicting Visual Outcome following Surgery for Idiopathic Macular Holes

Kusuhara

Negi

2013

Ophthalmologica

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“…4 However, the value of face-down positioning following surgery is unproven. Results of a number of studies question the value of posturing, demonstrating favourable outcomes with shortened durations of posturing, [5][6][7] and with no posturing at all. [8][9][10] Furthermore, face-down positioning is an arduous challenge and the prospect can be a significant deterrent to surgery for some people.…”

Section: Introductionmentioning

confidence: 99%

Pilot randomised controlled trial of face-down positioning following macular hole surgery

Lange

Membrey

Ahmad

et al. 2011

Eye

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Objective This was a pilot randomised controlled trial (RCT) to investigate the effect of post-operative face-down positioning on the outcome of macular hole surgery and to inform the design of a larger definitive study. Methods In all, 30 phakic eyes of 30 subjects with idiopathic full-thickness macular holes underwent vitrectomy with dye-assisted peeling of the ILM and 14% perfluoropropane gas. Subjects were randomly allocated to posture face down for 10 days (posturing group) or to avoid a face-up position only (non-posturing group). The primary outcome was anatomical hole closure. Results Macular holes closed in 14 of 15 eyes (93.3%; 95% confidence interval (CI) 68-100%) in the posturing group and in 9 of 15 (60%; 95% CI 32-84%) in the non-posturing group. In a subgroup analysis of outcome according to macular hole size, all holes smaller than 400 lm closed regardless of posturing (100%). In contrast, holes larger than 400 lm closed in 10 of 11 eyes (91%; 95% CI 58-99%) in the posturing group and in only 4 of 10 eyes (40%; 95% CI 12-74%) in the non-posturing group (Fisher's exact test P ¼ 0.02). Conclusion Post-operative face-down positioning may improve the likelihood of macular hole closure, particularly for holes larger than 400 lm. These results support the case for a RCT.

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“…These platelet preparations have been applied in diverse clinical fields. They have been used locally by ophthalmologists as an adjuvant to the ophthalmologic treatment of macular holes [10,11]; they have been used in cases of bone grafting showing to promote bone formation [12,13]; and they have proved effective in healing of chronic venous ulcers in cases of vascular surgery and dermatology [14,15]. Platelet concentrates has also been found to enhance healing of various kinds of wounds [16,17].…”

Section: Discussionmentioning

confidence: 99%

Determining the Effect of Preparation and Storage: An Effort to Streamline Platelet Components as a Source of Growth Factors for Clinical Application

Sonker

Dubey

2015

Transfus Med Hemother

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Background: In the present study, different methods for preparation of platelet-rich plasma (PRP) are investigated in order to standardize the component in terms of growth factor content. The effects of concentration technique and storage duration are also analyzed. Methods: PRP was collected from 40 donors by plateletpheresis as well as by the buffy coat and tube method. Concentration of growth factors was performed using double freeze thaw- and CaCl₂-induced degranulation techniques. Growth factor estimation was performed using ELISA. Results: The levels of growth factors were highest in PRP from buffy coat, moderately lower in plasma gained by plateletpheresis and lowest in that obtained by the tube method. Mean levels of platelet-derived growth factors (PDGF) AB and BB are significantly higher when CaCl₂ was used for concentrating the growth factors. The mean levels of transforming growth factor β1 and insulin-like growth factor I were higher when applying the double freeze thaw technique. There was a substantial decline in the levels of growth factors during storage. Conclusion: The buffy coat method is suitable as preparation method for PRP in most settings. The double freeze thaw technique is better suited as concentration technique as it causes lysis of both platelets and white blood cells for releasing growth factors and is easier to perform. Growth factors are not stable in plasma, thus PRP should be frozen immediately after preparation.

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Visual and anatomical success with short-term macular tamponade and autologous platelet concentrate

Cited by 36 publications

References 31 publications

Predicting Visual Outcome following Surgery for Idiopathic Macular Holes

Predicting Visual Outcome following Surgery for Idiopathic Macular Holes

Pilot randomised controlled trial of face-down positioning following macular hole surgery

Determining the Effect of Preparation and Storage: An Effort to Streamline Platelet Components as a Source of Growth Factors for Clinical Application

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