Abstract
Purpose :
To evaluate retinal functional recovery, in the macular region of the subretinal internal limiting membrane (ILM) transplantation in patients after ILM transplantation for persistent full thickness macular hole (FTMH).
Methods :
In this prospective observational, consecutive case series, patients were included who underwent vitrectomy with subretinal ILM transplantation and air tamponade for large persistent FTMH after prior unsuccessful vitrectomy with posterior hyaloid detachment and ILM peeling. For all eyes, high-definition spectral domain optical coherence tomography scans (SD-OCT Spectralis, Heidelberg Engineering GmbH, Germany) of the macula, Clarus fundus photography (ZEISS Clarus), visual acuity testing (qVA) and microperimetry analysis (MAIA, 4-2 strategy, 10-2°, 72 points) were obtained at least 6 weeks after the surgery.
Results :
5 consecutive eyes (4 female, 1 male) were included. The mean (min-max) age was 70 years (65-75). The mean preoperative diameter of the macular hole (MH) was 627µm (511-835). Mean follow-up was 28.8 months (12-54). In all cases ILM transplantation resulted in anatomical closure of the MH during the follow up period. Mean retinal sensitivity was 17.1 dB (14.5-21.30, normal >25dB) and fixation stability measured as bivariate contour ellipse area (BCEA) was 6.8 deg^2 (3.9-13.3deg^2, normal 2.40 ± 2.04deg^2). All patients demonstrated to have a preferred retinal locus located in the upper and nasal area of the previous MH with at least partial coverage of the ILM transplant.
Conclusions :
Autologous subretinal ILM transplantation does result in anatomic closure and it can lead to partial recovery of visual function in persistent FTMH. This technique seems to be a reasonable alternative procedure for long-standing or persistent FTMH to achieve anatomic closure and partial functional recovery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.