Combined Amniotic Membrane Graft and Autologous Retinal Transplant for Repair of Refractory Chronic Myopic Macular Holes

Abstract

To report a technique for reconstruction of large, persistent, chronic, myopic macular holes using a combined human amniotic membrane graft and autologous retinal transplant (AMN-ART). Three patients with large, myopic macular holes that failed prior surgical attempts and underwent subretinal amniotic membrane graft with overlying autologous retinal transplant and short-term perfluorocarbon tamponade. Pre- and postoperative visual acuity (VA) and images were analyzed at 3, 6, and 9 months. All 3 myopic macular holes remained closed at 9 months with resolution of central scotoma. The first case, a 69-year-old female, presented with a persistent macular hole whose minimum linear diameter was 1085 μm. Her pre-op VA of 20/200 improved by 9 months to 20/100. Secondly, a 72-year-old male with history of recurrent retinal detachment repair with silicone oil and persistent macular hole of 1134 μm presented with pre-op VA of 20/200, which was unchanged at 9 months. Lastly, a 76-year-old female with a persistent macular hole of 935 μm with preop VA of 20/80 improved by 9 months post-op to 20/50. No complications were encountered related to the grafts. Combined AMN-ART may provide a surgical option for repair of refractory, large, chronic myopic macular holes with underlying atrophy.