Purpose
Large macular holes usually have an increased risk of surgical failure. New surgical techniques have been reported to avoid the failure of macular hole closure. This article presents the anatomical and functional results of autologous transplantation of the internal limiting membrane (ILM) for large macular holes.
Methods
A prospective interventional study of 26 consecutive patients who underwent autologous transplantation of the ILM for the treatment of large macular holes (minimum linear diameter > 400µm) were studied. There were 10 male patients (38%) and 16 female patients (62%). The average age was 56 years (19-78 years). All surgeries were performed by the same surgeon. Exclusion criteria included vitrectomy concurrent with intraocular lens implantation, glaucoma, and other progressive retinal diseases. In the autologous transplantation technique, a small piece of the ILM was peeled off to make a free flap, and this was transplanted and placed inside the macular hole. Fluid-air exchange was then performed. Spectral optical coherence tomography and clinical examination were performed before surgery and postoperatively at 1 week and 1, 3, 6, and 12 months.
Results
Macular holes were closed successfully in 26 eyes (100%) after autologous transplantation of the ILM. 24 eyes (92.3%) were classified into the U-shape closure and 2 eyes (7.7%) into the flat-open closure. The postoperative BCVAs were significantly better than the preoperative BCVAs (P = .001, paired t test).
Conclusions
The results suggest that autologous transplantation of the ILM might contribute to a high closure rate of macular hole and be a preferable adjuvant to the treatment of large macular holes.