scholarly journals Successful Technique for Closure of Macular Hole Retinal Detachment Using Autologous Retinal Transplant

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Juan Abel Ramirez-Estudillo ◽  
Geovanni Rios-Nequis ◽  
Martin Jimenez-Rodríguez ◽  
Hugo Valdez-Flores ◽  
Ximena Ramirez-Galicia

Macular hole retinal detachment (MHRD) for the most part develops in highly myopic eyes. Several surgical methods have been introduced to treat MHRD. We describe our experience with the autologous retinal transplant in patient with MHRD. A 49-year-old female presented with a 2-week history of a sudden decrease in the central vision in the right eye (RE). A 3-port, 25-gauge pars plana vitrectomy was performed with the ILM dye staining and peeling. Endodiathermy was applied around a 1.5-disc diameter neurosensory donor site in the supertemporal retina. The graft was cut with standard 25-gauge curved scissors. Perfluoro-n-octane (PFO) was instilled. The free graft was gently handled until its packing into the macular hole. Two months following the initial PPV, the macular hole was closed, and vision improved from 0.05 to 0.25 logMAR.

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed M. Bedda ◽  
Ahmed M. Abdel Hadi ◽  
Muhammad S. Abd Al Shafy

Aim.To compare pars plana vitrectomy (PPV) with silicone tamponade or gas (Groups Ia and Ib) and a new modified Ando plombe equipped with a fiber optic light (Group II) for cases with macular hole retinal detachment (MHRD) in high myopic eyes (axial length > 26 mm).Methods.A prospective interventional randomized case series included 60 eyes (20 in each group). Successful outcome was considered if the retina was completely attached at the end of the follow-up period. Complications were identified for each group.Results.Visual acuity improved by 37.31%, 40.67%, and 49.40% in Groups Ia, Ib, and II, respectively. The success rate was 55%, 60%, and 100% in Groups Ia , Ib, and II, respectively, with a statistically significant difference between Groups Ia, Ib, and II (p< 0.001 in Ia,p: 0.002 in Ib). Complications rates were 60%, 45%, and 20% in Groups Ia, Ib, and II, respectively, with a statistically significant difference between Groups Ia and II (p: 0.01).Conclusion.Fiber optic illuminated Ando plombe allows better positioning under the macula and consequently improves the success rate of epimacular buckling in comparison to PPV with internal tamponade in MMHRD.


2021 ◽  
pp. 967-974
Author(s):  
Dean Ouano ◽  
Rachel Huynh ◽  
Alyson Nicole Tukan ◽  
Nour Bundogji ◽  
Majid Moshirfar

A 73-year-old male with a history of myopic laser-assisted in situ keratomileusis (LASIK) 20 years earlier presented with a late LASIK flap dehiscence, epithelial ingrowth, conjunctivalization, and the development of a pseudopterygium in the right eye. The findings were consistent with surgical trauma, likely occurring after corneal epithelial debridement to improve visualization during pars plana vitrectomy for retinal detachment repair 3 months earlier. The patient underwent epithelial ingrowth debridement, LASIK flap reapproximation and suturing, and a conjunctival limbal autograft from the contralateral eye. The surgery was completed successfully without the need for flap amputation. Postoperatively, the patient had an uneventful course with a well-healing conjunctival graft and no interface opacity or evidence of recurrent pseudopterygium of the right eye. The graft and corneal topography remained stable after subsequent cataract surgery.


2021 ◽  
Vol 62 (12) ◽  
pp. 1672-1678
Author(s):  
Sung Joon Kim ◽  
Jae Jung Lee ◽  
Ik Soo Byon ◽  
Ji Eun Lee ◽  
Sung Who Park

Purpose: To report a case of poor visual prognosis complicated by residual subretinal fluid after use of the internal limiting membrane flap technique to treat macular hole retinal detachment in a patient with high myopia.Case summary: A 55-year-old male stated that he had experienced a transparent circle in the central visual field of the right eye for 1 month. His best-corrected visual acuity (BCVA) was 0.32 and the axial length of the right eye was 32.57 mm. Fundus examination revealed a macular hole with retinal detachment localized to the posterior pole. We performed vitrectomy, membrane peeling, internal limiting membrane peeling with inverted internal limiting membrane flap, and silicone oil injection. On day 1 after surgery, the macular hole was closed, but subretinal fluid was noticed in the macula. At 3 months after surgery, the BCVA was 0.16 and the silicone oil was removed. At 14 months after the first surgery, the subretinal fluid was completely absorbed, but leopard-pattern pigment degeneration became prominent and the macula exhibited ellipsoid zone disruption. The BCVA decreased to 0.1.Conclusions: In patients exhibiting macular hole retinal detachment in the context of high myopia, an inverted internal limiting membrane flap may increase the macular hole closure rate but disturb subretinal fluid drainage. As persistent subretinal fluid may cause permanent retinal damage with a poor visual prognosis, the surgical method must be carefully chosen.


2021 ◽  
Vol 8 ◽  
Author(s):  
Zhigao Liu ◽  
Shuya Wang ◽  
Yu Wang ◽  
Aihua Ma ◽  
Bojun Zhao

Background: This study aimed to report a case of vitrectomy with peeling the internal limiting membrane for the treatment of macular hole (MH) following ruptured retinal arterial macroaneurysm (RAMA).Case Presentation: A 65-year-old woman noticed a sudden decrease in vision in the left eye. She had no other ocular problems apart from a mild cataract in both eyes before. Her best-corrected visual acuity (BCVA) was 20/33 in the right eye, and 6/100 in the left eye. Fluorescein angiography (FFA) showed a retinal arterial macroaneurysm with telangiectatic retinal vascular changes in the inferior temporal macular region. Optical coherence tomography (OCT) examination demonstrated the presence of subretinal hemorrhage extending into the foveal area and incomplete posterior vitreous detachment. Because of the presence of submacular hemorrhage, some medicine was administrated and the patient was followed up. Then, 5 months later, the hemorrhage was absorbed. OCT examination exhibited a full-thickness MH with a macular epiretinal membrane. The size of the MH was 722 μm in diameter. She was then given a standard three-port pars plana vitrectomy (PPV), along with peeling of the internal limiting membrane (ILM) and filling the vitreous cavity with air. Anatomic closure of the MH was achieved after 4 weeks of the surgery by the examination of OCT. The BCVA was improved to 15/100.Conclusions: This case expanded our knowledge of the association of MH secondary to ruptured RAMA. We reported a case with successful surgical closure of the MH and improvement of BCVA.


2018 ◽  
Vol 9 (1) ◽  
pp. 119-125 ◽  
Author(s):  
Yumi Iwakawa ◽  
Hisanori Imai ◽  
Hiromi Kaji ◽  
Yuki Mori ◽  
Chihiro Ono ◽  
...  

Purpose: To report a case of macular hole (MH) secondary to a retinal arterial macroaneurysm (RAMA) which was successfully treated with an autologous transplantation of internal limiting membrane (ILM). Case Report: An 87-year-old female presented with a sudden decrease in central vision in the right eye. A fundus examination revealed a RAMA in the superonasal macular region, a subretinal hemorrhage (SRH), involving the macula, and a sub-ILM hemorrhage. A pars plana vitrectomy (PPV) was performed. Intraoperatively, an MH filled with coagulum was detected. We tried to blow off and drain the SRH with a current of BSS and a gentle suction with a 27-gauge vitreous cutter from the MH, but some amount of SRH at the bottom of the MH remained. The ILM was peeled off for 2 disc diameters around the MH. The vitreous cavity was filled with air at the end of the operation. Two weeks after the surgery, the MH was not closed. One month following the initial PPV, a second PPV was performed to achieve closure of the MH. Results: An autologous transplantation of ILM was performed as second PPV. Six months after the final surgery, the MH was successfully closed and the best-corrected decimal visual acuity was 0.6. Conclusions: Autologous ILM transplantation can be an effective treatment option for MH closure following RAMA rupture.


2018 ◽  
Vol 10 (1) ◽  
pp. 77-81
Author(s):  
B N Kalpana ◽  
Y D Shilpa ◽  
Sneha Priya Prabhakar ◽  
S M Ram Prakash ◽  
B C Hemalatha ◽  
...  

Background: Management of Rhegmatogenous Retinal Detachment (RRD) in keratoconus could be challenging in various aspects. Visualisation of fundus due to altered reflex along with axial myopia could pose difficulty while performing pars plana vitrectomy. Our patient underwent Scleral Buckling with good anatomical results. We came across an isolated case of Keratoconus with Retinal detachment without any pre existing comorbidities unlike earlier reports where patients with history of atopic dermatitis had Keratoconus associated with RRD. The main purpose was to know the outcome of scleral buckling and its effect on corneal topography in a case of keratoconus with RRD.Case: A 35 year old female presented with diminution of vision in both eyes since childhood, but more so in the right eye (RE) since last 6 months. She was aphakic with VA of 1/60 and 2/60 in the right and left eye respectively. She was diagnosed as both eyes keratoconus with RE near total rhegmatogenous retinal detachment (RRD) with sub retinal gliosis. She gave no history of vigorous eye rubbing or atopic dermatitis. For RE she underwent uneventful scleral buckling surgery.Observation: In post operative follow up, the retina was attached. Placido based corneal topography was done pre operatively with keratometry reading of RE – K1 62.79@96º, K2 – 55.92@6˚ and repeated at the end of three months follow up with readings of RE – K1-61.45@98˚, K2- 54.50@ 8˚. There were minimal changes in the keratometry values post operatively with flattening of vertical meridian and horizontal meridian.Conclusion: In keratoconus, RD can occur without any predisposed or preceding condition. Although majority of cases are associated with atopic dermatitis and eye rubbing. Scleral buckling (SB) was successful with good functional and anatomical outcome., however it has minimal effect on corneal topography.  


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xianggui Wang ◽  
Xuezhi Zhou ◽  
Ying Zhu ◽  
Huizhuo Xu

Abstract Background To investigate the feasibility and efficacy of posterior pole retinotomy to treat recurrent macular hole retinal detachment (MHRD) in highly myopic patients. Methods We performed a retrospective study and reviewed the medical records in our hospital between January 1, 2016 and December 31, 2018. Highly myopic patients who received posterior pole retinotomy with silicone oil tamponade for their recurrent MHRD after pars plana vitrectomy were included in the analysis. Postoperative retinal reattachment, best-corrected visual acuity (BCVA), macular hole closure, and complications were evaluated. Results There were 11 patients (11 eyes) included in this study. All retinas were reattached. Silicone oil was successfully removed from all eyes 1.5–3 months after the surgery. Macular holes were completely closed in three eyes and remained flat open in eight eyes. The BCVA of all eyes improved significantly at 12 months after surgery (logarithm of the minimal angle of resolution, pre vs. postoperatively, 1.87 ± 0.44 vs. 1.15 ± 0.24, P < 0.05). None of the patients had complications such as endophthalmitis, fundus hemorrhage, retinal redetachment, and proliferative vitreoretinopathy. Conclusion Posterior pole retinotomy is a safe and effective surgery to treat recurrent MHRD after pars plana vitrectomy in highly myopic patients.


Sign in / Sign up

Export Citation Format

Share Document