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A 24 month follow-up of refractory macular holes treated with an autologous transplantation of internal limiting membrane versus retina expansion technique

  • Alezzandrini, Arturo1
  • Dorrego, Camila I.1
  • Cibrán, María Victoria1
  • Cortina-Revelli, Valentina1
  • Rocco, Franco D.1
  • Zas, Marcelo1
  • Wu, Lihteh2
  • 1 University of Buenos Aires, Buenos Aires, Argentina , Buenos Aires (Argentina)
  • 2 Asociados de Macula, Vitreo y Retina de Costa Rica, San Jose, Costa Rica , San Jose (Costa Rica)
Published Article
International Journal of Retina and Vitreous
BioMed Central
Publication Date
Oct 02, 2021
DOI: 10.1186/s40942-021-00329-1
Springer Nature
  • Original Article


BackgroundTo compare the functional and anatomic outcomes at 24 months of eyes with a primary macular hole that failed to close after a prior surgery and were treated with either an autologous transplantation of internal limiting membrane (AT-ILM) or the retina expansion (RE) technique.MethodsRetrospective, single center, comparative study of 28 eyes with a macular hole that failed to close after a prior vitrectomy. All eyes had a size of ≥ 500 μm. Participants were divided into two groups according to the type of intervention performed: AT-ILM group (n = 14) and RE group (n = 14). Main outcomes measured were the MH closure rate assessed by spectral-domain optical coherence tomography (SD-OCT) and the best-corrected visual acuity (BCVA) at 24 months after surgery.ResultsPatients in the AT-ILM group experienced a statistically significantly improved post-operative BCVA (median 49.50 letters, range 20–66 letters) over the pre-operative BCVA (median 39 letters, range 18–52 letters) (p-value = 0.006 Wilcoxon paired sample test). In contrast, patients in the RE group did not achieve a statistically significant improvement (p-value = 0.328, Wilcoxon paired sample test). The median pre-operative BCVA was 35 letters (range 18–52 letters), whereas the median post-operative BCVA was 39 letters (range 16–66 letters). At 24 months of follow-up, 85.7% of patients in the AT-ILM group achieved closure compared to 57.1% in the RE group (p-value = 0.209, Fisher’s exact test). Multivariate analysis showed that MH size and baseline BCVA were important determinants of post-operative BCVA. The baseline MH size was the only significant pre-operative factor that influenced MH closure.ConclusionsThis study demonstrates similar closure rates for both groups however better visual outcomes were obtained with the AT-ILM.

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