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. 2021 Oct 2;7(1):57.
doi: 10.1186/s40942-021-00329-1.

A 24 month follow-up of refractory macular holes treated with an autologous transplantation of internal limiting membrane versus retina expansion technique

Arturo Alezzandrini  1 , Camila I Dorrego  2 , María Victoria Cibrán  2 , Valentina Cortina-Revelli  2 , Franco D Rocco  2 , Marcelo Zas  3 , Lihteh Wu  4
Affiliations

A 24 month follow-up of refractory macular holes treated with an autologous transplantation of internal limiting membrane versus retina expansion technique

Arturo Alezzandrini et al. Int J Retina Vitreous. .

Abstract

Background: To compare the functional and anatomic outcomes at 24 months of eyes with a primary macular hole that failed to close after a prior surgery and were treated with either an autologous transplantation of internal limiting membrane (AT-ILM) or the retina expansion (RE) technique.

Methods: Retrospective, single center, comparative study of 28 eyes with a macular hole that failed to close after a prior vitrectomy. All eyes had a size of ≥ 500 μm. Participants were divided into two groups according to the type of intervention performed: AT-ILM group (n = 14) and RE group (n = 14). Main outcomes measured were the MH closure rate assessed by spectral-domain optical coherence tomography (SD-OCT) and the best-corrected visual acuity (BCVA) at 24 months after surgery.

Results: Patients in the AT-ILM group experienced a statistically significantly improved post-operative BCVA (median 49.50 letters, range 20-66 letters) over the pre-operative BCVA (median 39 letters, range 18-52 letters) (p-value = 0.006 Wilcoxon paired sample test). In contrast, patients in the RE group did not achieve a statistically significant improvement (p-value = 0.328, Wilcoxon paired sample test). The median pre-operative BCVA was 35 letters (range 18-52 letters), whereas the median post-operative BCVA was 39 letters (range 16-66 letters). At 24 months of follow-up, 85.7% of patients in the AT-ILM group achieved closure compared to 57.1% in the RE group (p-value = 0.209, Fisher's exact test). Multivariate analysis showed that MH size and baseline BCVA were important determinants of post-operative BCVA. The baseline MH size was the only significant pre-operative factor that influenced MH closure.

Conclusions: This study demonstrates similar closure rates for both groups however better visual outcomes were obtained with the AT-ILM.

Keywords: Hydrodissection; ILM free flap; Macular holes; Retina expansion.

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Conflict of interest statement

CID, MVC, VCR and FDR declare that they have competing interests.

AA has participated in advisory boards for Roche, Alcon, Bayer and Novartis.

MZ has received speaker fees from Alcon, Bayer, Abbvie, Poen and Novo Nordisk.

LW has received speaker fees from Bayer and Quantel Medical

Figures

Fig. 1
Fig. 1
Pre-operative and post-operative visual acuity distribution
Fig. 2
Fig. 2
Post-operative anatomic macular hole status
See this image and copyright information in PMC

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