Autologous transplantation of ILM has better visual outcomes for refractory macular hole
FORT LAUDERDALE, Fla.— Autologous transplantation of the internal limiting membrane showed comparable rates of macular hole closure but better visual outcomes than retina expansion surgery at 24 months of follow-up.
The retrospective study, presented at the Retina World Congress, compared the two techniques in two groups of 14 patients with macular hole (MH) between 500 µm and 800 µm, refractory to previous interventions.
“In group A, we performed pars plana vitrectomy, and after checking that there was no residual ILM at the sides of the MH, we performed a new ILM rhexis of 2 papillary diameters under [perfluorocarbon liquid]. The new ILM flap was then gently laid over the MH, and a complete fluid-gas exchange was performed,” Arturo Alezzandrini, MD, PhD, said.
In group B, pars plana vitrectomy was performed, the edges of the MH were checked for any residual internal limiting membrane (ILM) adhesions, and balanced salt solution was injected into the subretinal space using a 38-gauge cannula.
“This injection was performed to promote detachment and stretch the retinal area around the MH. A complete fluid-gas exchange was performed,” he said.
In the group treated with autologous ILM transplantation, complete MH closure was achieved in 12 cases, and after 24 months of follow-up, a statistically significant improvement in mean best corrected visual acuity was observed. In the group treated with the retina expansion technique, complete MH closure was achieved in 10 cases, but no statistically significant BCVA improvement was achieved at 24 months.
“Randomized prospective studies are needed to further confirm these findings and evaluate the complications of both techniques,” Alezzandrini said.
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Alezzandrini A. Autologous transplantation of ILM versus retina expansion technique for refractory macular holes. Presented at: Retina World Congress. May 12-15, 2022; Fort Lauderdale, Fla.
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