Human amniotic membrane graft with viscodissection and intraoperative OCT for macular hole repair

Abstract

Objective: To present the human amniotic membrane (hAM) graft with the novel addition of viscodissection and usage of intraoperative OCT as a potential approach to treating challenging macular holes and to describe the outcomes. Design: Retrospective interventional case series. Participants: 10 patients with large, chronic, or persistent macular holes were included in this study. Methods: 10 eyes of 10 patients were treated using a hAM graft with viscodissection. Intraoperative OCT was utilized to assist the placement of the graft. Outcomes were monitored through clinical examinations, retinal imaging, and OCT. Results: Macular holes were closed in all 10 patients and remained so during the entirety of the follow-up periods. 9 out of 10 patients experienced an improvement in visual acuity. Mean best corrected visual acuity increased from 1.68 logMAR (20/1000) preoperative to 0.74 logMAR (20/100) at 6 months postoperative. No adverse events were observed for any of our patients. Conclusions: The addition of viscodissection to the standard hAM graft surgery is a potential optimization that reduces risks of iatrogenic damage to the retina. Surgeons can consider including this approach as part of their arsenal to treat such macular holes.

Keywords

• Viscodissection
• Macular hole
• Human amniotic membrane
• Surgical risk