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Autologous retinal graft surgery for refractory macular holes without postoperative head positioning

Retina. 2025 Apr 16. doi: 10.1097/IAE.0000000000004488. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the efficacy of autologous retinal graft (ARG) surgery using a novel technique of Viscoat as a graft adherent and stabilizer for large, refractory macular holes (MHs) without postoperative face-down positioning.

METHODS: This retrospective interventional case series included 13 patients with refractory MHs who underwent ARG surgery. The surgical technique involved retinal graft placement stabilized with Viscoat, without postoperative positioning. Preoperative, 6 months and 12 months postoperative outcomes, including MH closure rates and visual acuity (VA) were analyzed.

RESULTS: Pre-op mean MH size was 821.69 ± 180.65 µm (range: 563-1200 µm). Anatomical closure was achieved in 76.9% (10/13) of cases. Median VA improved from 1.7 logMAR (20/1000) preoperatively to 1.3 logMAR (20/400) at 6 months and at 12 months postoperatively, although this change was not statistically significant (p = 0.106 and p = 0.311 respectively). No major complications were reported. Larger MH size and chronicity might limit functional improvement despite successful closure.

CONCLUSION: This is the first study to demonstrate that ARG surgery with Viscoat can achieve high closure rates without postoperative head positioning. The technique offers a patient-friendly alternative for refractory MH management, reducing postoperative burden while maintaining promising anatomical outcomes. Further studies with larger cohorts are warranted to validate these findings.

PMID:40258292 | DOI:10.1097/IAE.0000000000004488

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