Human Amniotic Membrane Graft Transplantation for Treating Recurrent High Myopic Large Macular Hole.

Purpose: This study investigated the use of human amniotic membrane (hAM) graft transplantation for treating recurrent large macular holes in highly myopic patients, particularly in cases resistant to standard surgical methods.

Methods: Seven eyes from six highly myopic patients with recurrent large macular holes (>400 μm) underwent hAM transplantation supported by perfluorocarbon liquid (PFCL) and ophthalmic viscoelastic devices (OVD). All patients had previously undergone pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. The hAM graft, sized to cover the macular area, was carefully positioned with PFCL and OVD assistance to enhance surgical control and prevent graft displacement.

Results: Complete macular hole closure was achieved in most cases. Best-corrected visual acuity (BCVA) was either preserved or improved, with no complications such as retinal detachment or graft displacement. The modified technique also reduced the need for prolonged prone positioning, minimizing postoperative discomfort for patients.

Conclusion and importance: hAM graft transplantation with PFCL and OVD is a safe and effective method for managing large, recurrent macular holes in highly myopic eyes. This technique enhances graft handling, simplifies surgery, and achieves high closure rates with stable visual outcomes, offering a promising solution when conventional methods are inadequate.