Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;41(3):1043-1052.
doi: 10.1007/s10792-020-01662-4. Epub 2021 Jan 3.

Surgical treatment of macular holes with and without the use of autologous platelet-rich plasma

Alexander A Shpak  1 , Dmitry O Shkvorchenko  2 , Eugenia A Krupina  2
Affiliations

Surgical treatment of macular holes with and without the use of autologous platelet-rich plasma

Alexander A Shpak et al. Int Ophthalmol. 2021 Mar.

Abstract

Purpose: To compare the results of treatment of idiopathic full-thickness macular holes (MHs) with and without the use of autologous platelet-rich plasma (APRP).

Methods: This partially retrospective study included 152 patients (152 eyes) with MHs operated in the years 2010-2014 using conventional technology with internal limiting membrane peeling (control group) and 62 patients (62 eyes), operated by the same surgeons in 2015-2017 with additional application of APRP on MH (platelet group). Pre and postoperative best-corrected visual acuities (BCVA) were recorded, and retinal microstructure was studied using optical coherence tomography. Thirty-seven patients in the platelet group and 80 controls were followed for at least 12 months (for visual outcomes 15 controls were followed for 15-24 months). The data of 72 controls (72 eyes) were analyzed retrospectively.

Results: The minimum diameter of the MH in the platelet group was larger than in controls: 454 ± 186 vsersus 381 ± 148 μm (P = 0.003). Despite this, all MHs in the platelet group were closed, while in the control group 11 holes (7.2%) remained open (P = 0.036). The final mean BCVA, standardized by the minimum diameter of the macular hole, was higher in the platelet group by 3.9 ETDRS letters (P = 0.012). After surgery with APRP, foveal hyperreflective lesion (presumably glial proliferation) was found, which persisted in most large MHs, but gradually disappeared in small and most medium MHs.

Conclusion: The use of APRP significantly improves the anatomical and functional results of treatment of idiopathic MHs. In very large MHs, APRP presumably enhances glial proliferation, which ensures their closure.

Keywords: Anatomical outcome; Idiopathic macular hole; Optical coherence tomography; Platelet-rich plasma; Surgery; Visual acuity.

PubMed Disclaimer

References

    1. Gaudric A, Massin P, Paques M, Santiago PY, Guez JE, Le Gargasson JF, Mundler O, Drouet L (1995) Autologous platelet concentrate for the treatment of full-thickness macular holes. Graefes Arch Clin Exp Ophthalmol 233(9):549–554. https://doi.org/10.1007/BF00404704 - DOI - PubMed
    1. Paques M, Chastang C, Mathis A, Sahel J, Massin P, Dosquet C, Korobelnik JF, Le Gargasson JF, Gaudric A (1999) Effect of autologous platelet concentrate in surgery for idiopathic macular hole: results of a multicenter, double-masked, randomized trial. Platelets in Macular Hole Surgery Group. Ophthalmology 106(5):932–938. https://doi.org/10.1016/s0161-6420(99)00512-6 - DOI - PubMed
    1. Vote BJ, Membrey WL, Casswell AG (2004) Autologous platelets for macular hole surgery: the Sussex Eye Hospital experience. Clin Experiment Ophthalmol 32(5):472–477. https://doi.org/10.1111/j.1442-9071.2004.00866.x - DOI - PubMed
    1. Cheung CMG, Munshi V, Mughal S, Mann J, Hero M (2005) Anatomical success rate of macular hole surgery with autologous platelet without internal-limiting membrane peeling. Eye 19(11):1191–1193. https://doi.org/10.1038/sj.eye.6701733 - DOI - PubMed
    1. Kapoor KG, Khan AN, Tieu BC, Khurshid GS (2012) Revisiting autologous platelets as an adjuvant in macular hole repair: chronic macular holes without prone positioning. Ophthalmic Surg Lasers Imaging 43(4):291–295. https://doi.org/10.3928/15428877-20120426-03 - DOI - PubMed

LinkOut - more resources