MACULAR HOLE RECOVERY SURGERY USING AUTOLOGOUS PLATELET RICH PLASMA

Abstract

The aim of this study was to evaluate the long-term outcomes of highly concentrated autologous platelet-rich plasma (PRP) used as an adjunct inmacular hole surgery. Materials and methods: 11 patients (11 eyes) were selected for surgical treatment, of which 9 patients were female and 2 males. 10 patients (10 eyes) had primary macular tears, of which 8 eyes had grade 4 and 2 eyes had grade 3 macular tears and one patient had post-traumatic macular tear. The age of patients with primary macular tear was 59-75 years, and the patient with traumatic macular tear was 32 years old. Visiometry, tonometry, ophthalmoscopy, biomicroscopy, echography of the eyeball, and optical coherence tomography of the retina were performed on all patients before the operation and in the postoperative period. The patients were operated under local anesthesia (2% 2ml Lidocaine and 0.75% 2ml Bupivacacaine) in the following way: 25 Gauge standard pars plana vitrectomy with mandatory removal of the posterior hyaloid membrane, after which peeling of the internal limiting membrane of the retina was performed with a large volume. Platelet-rich plasma was separated under sterile conditions in the operating theatre. It was introduced into the macular hole region in the end of surgery and 8% octafluoropropane gas (C3F8) was introduced into the eye. Results: There were no complications during surgery or in postoperative period. Optic coherence tomography of the macula was performed on the 7th day after surgery. In all 11 cases there was anatomical closure of the macular holes. Visual acuities were measured on days 14 and 3. On average there was an improvement in visual acuity by 2 lines according to Snellen chart, disappearance of metamorphopsia and image distortion. During the follow up the patients during 6 month there was no development cataract, retinal tears or detachment, late endophthalmitis or any other complications. Conclusion: During the surgical treatment of patients with primary and secondary macular holes the use of autologous platelet rich plasma promotes the anatomical closure of the holes, as a result of which metamorphopsias and central scotomas disappear and an increase in visual acuity is observed.