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Heparinized blood may be alternative to staining for ILM removal during macular hole surgery

Ophthalmology. 2009;116(8):1525-1530.

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Autologous heparinized blood used to coat the macular surface after vitrectomy may aid in the visualization of the internal limiting membrane during surgery to repair macular hole.

The strategy may prove useful as an alternative to stains, which are commonly used to help identify the internal limiting membrane (ILM) but may carry risk of toxicity.

"In this study, the whole blood highlighted the contrast of the coated and noncoated area during the ILM peeling procedure," the study authors said. "Autologous heparinized whole blood is a cost-effective and easily available material, and thus is an alternative to other ... chemical dyes or triamcinolone acetonide for assistance with ILM peeling."

For the study, 32 eyes of 29 patients with stage 2 to 4 macular holes were operated with core vitrectomy, followed by whole blood to coat the macula. Redundant blood was removed, and a thin film of blood was left to coat the ILM, which was removed with forceps.

At 12 months of follow-up, all holes were successfully closed with a single surgery, and no toxicity was noted. Best corrected vision improved from 1.02 logMAR at baseline to 0.53 logMAR at the end of the study.