ArticleInternational journal of retina and vitreous2025
Refractory macular hole surgery with amniotic membrane transplant functional assessment.
Article in International journal of retina and vitreous, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate refractory macular hole (MH) surgery with amniotic membrane transplant functional outcomes.
methodsProspective study over a five-year period. Nineteen patients with full-thickness macular hole (15 refractory MH and 4 chronic ≥ 8 years MH) were included. All patients underwent vitrectomy, cryopreserved amniotic membrane subretinal graft, tamponade and positioning. Functional outcomes were assessed using best-corrected visual acuity, M-CHARTS™ and mfERG (P1 and N1 waves amplitude and implicit time in five rings and ratios) preoperatively, at 3- and 12-months follow-up. Optical coherence tomography was also performed for structure-function analysis.
resultsMean follow-up was 45 months (range 15–68). Mean MH minimum linear diameter was 819 ± 242 μm and base diameter was 1387 ± 346 μm. After surgery, MH closed in all patients. Mean logarithm of the minimum angle of resolution (logMAR) visual acuity improved significantly from 1.70 ± 0.40 to 1.12 ± 0.39 (p < 0.001), mean first ring P1 amplitude, P1 implicit time, N1 amplitude and ratio 2 increased significantly (ß = 19.82, p = 0.029), (ß = 6.72, p = 0.033), (ß = 10.76, p = 0.007) and (ß = 0.836, p = 0.011), respectively. Foveal peak improved in 60% patients, one third presenting eccentric positioning.
conclusionsVisual acuity, metamorphopsia and mfERG improvements postoperatively suggest that amniotic membrane graft may be a useful tool to achieve refractory macular hole closure and enhanced functional outcomes.
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