Autologous Retinal Transplant for Macular Hole

Sergio E Hernández Da Mota,Virgilio Morales-Cantón,Lisette Béjar Macouzet,Abel Ramírez-Estudillo,Antonio López-Bolaños,Sergio Rojas-Juárez

doi:10.2174/1874364102115010292

Sergio E Hernández Da Mota, Virgilio Morales-Cantón + Show 4 more

Open Access

https://doi.org/10.2174/1874364102115010292

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Abstract

We aim to review scientific literature concerning published studies on autologous retinal transplantation to treat macular hole patients. The following databases were searched: Medline and Medline Non-Indexed Items, Embase (1990–2020), Ovid Medline® (1990 to November 2020), Embase (1990 to November 2020), Ovid Medline® and Epub Ahead of Print, in-Process and Web of Science (all years). Search keywords included “autologous”, “retinal transplant”, “autologous neurosensory retinal free flap” “transplantation”, “macular hole”, and “macular hole surgery”. Eighteen case series and single case reports were reviewed. Preoperative and final best-corrected visual acuity, microperimetry and multifocal electroretinogram findings, macular hole closure rate, preoperative and postoperative ellipsoid zone, and external limiting membrane defects were obtained and analyzed. Indications of autologous retinal transplantation for macular hole surgery included refractory macular holes, conventional techniques, and large macular holes. The number of cases included in the different case series ranged from 2 to 130 cases, and prior macular hole surgeries of the patients ranged from 0 to 3. Overall, the published case series of autologous retinal transplants have reported a macular hole closure rate of 66.7 to 100%, as well as a significant improvement in best-corrected visual acuity. The most frequently reported complications included considerable intraoperative bleeding and postoperative dislocation of the graft. The presence of functionality in the graft area has also been documented by microperimetry and multifocal electroretinogram. In conclusion, the autologous retinal transplantation technique for macular hole patients has emerged as another surgical option, with a high macular hole closure rate and visual improvement.

Highlights

Wendel and Kelly published the first series of cases with idiopathic MH presence successfully treated with vitrectomy [1]
This review aims to describe some technical variants, the anatomical and functional results of the case series of autologous retinal transplantation (ART) for MH published to date
Different tamponade types have been used to keep the graft in place to prevent its dislocation

Summary

Introduction

Wendel and Kelly published the first series of cases with idiopathic MH presence successfully treated with vitrectomy [1].Since MH surgery’s original description, multiple variants to the original technique have been described [2 - 10]. Wendel and Kelly published the first series of cases with idiopathic MH presence successfully treated with vitrectomy [1]. Peeling the internal limiting membrane is one of the modifications to the original MH surgery technique that has increased the MH closure rate [2]. In up to 10% of the operated cases, the MH closure is not achieved with conventional surgery [5]. Several other techniques have been described for the treatment of MH hole patients. Some of these techniques use transplanted tissue either from the patient’s eye or another donor, achieving the MH’s closure through various mechanisms [3 - 10]

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