THE LONG-TERM FOLLOW-UP OF AUTOLOGOUS BLOOD CLOT-ASSISTED LYOPHILIZED HUMAN AMNIOTIC MEMBRANE COVERING TREATMENT UNCLOSED MACULAR HOLE

Abstract

Purpose: The objectives were to assess the long-term morphologic and functional outcome of eyes with unclosed macular hole (MH) in which the internal limiting membrane has been peeled in previous vitrectomy with autologous blood clot-assisted lyophilized human amniotic membrane (LhAM) graft covering. Methods: Twelve eyes with MH unclosed in previous surgery were selected and studied. Autologous blood clot-assisted LhAM graft was used to cover the MH in vitrectomy. The main clinical outcomes including best-corrected visual acuity, closure of MH, and the outcome of LhAM graft were recorded. Results: The mean minimum diameter of the MH was 641.7 ± 245.9 µm and the mean axial length was 27.3 ± 3.50 mm. The LhAM graft was maintained in the former position and all the MH closed in 10 eyes, whereas the graft slipped and the MH unclosed in two eyes. The MH closure rate was 83.3% and the mean best-corrected visual acuity improved significantly from 1.47 ± 0.58 logMAR (Snellen 20/590) preoperatively to 1.17 ± 0.60 logMAR (Snellen 20/296) postoperatively. During 18 to 36 months follow-up, LhAM grafts were attached to the retinal surface in nine eyes, detached from the retinal surface in one eye, dislocated from the fovea in one eye, and inserted into the retina in one eye; and macular atrophy occurred in one eye. Conclusion: Autologous blood clot-assisted LhAM graft covering provided a simple and effective treatment option for unclosed MH and reduce surgical trauma. Although the graft remained on the macular surface for a long time, it did not affect the recovery of MH and postoperative vision.