Efficacy of Split-Thickness Thin Amniotic Membrane Graft for Closure of Refractory or Large Macular Holes.

Purpose: To assess the effectiveness of split-thickness amniotic membrane (SAM) grafts in achieving closure of refractory or large macular holes (MH).

Methods: This retrospective study reviewed data from patients who underwent surgical repair of MHs using SAM grafts between January 2019 and December 2023. Key parameters, including best-corrected visual acuity (BCVA) and MH size, were evaluated both preoperatively and postoperatively.

Results: The study included 13 patients (9 females; mean age 63.5 years). Before surgery, the median BCVA was 1.30 ± 0.56 LogMAR (approximate Snellen equivalent: 20/400), and the median MH size measured 717 ± 246.6 µm. After an average follow-up period of 28 months, the median BCVA improved significantly to 1.00 ± 0.52 LogMAR (p < 0.05) (approximate Snellen equivalent: 20/200). All MHs were successfully closed, and no intraoperative complications were observed.

Conclusion: SAM grafting is a safe and reliable option for closing refractory or large MHs, resulting in significant improvements in BCVA and successful hole closure. Compared to full-thickness grafts, SAM grafts offer advantages such as increased flexibility in placement and ease of removal post-closure, due to their thinner and more pliable nature, which facilitates easier handling and positioning within the MH.