Department of Translational Surgery and Medicine, Ophthalmology, University of Florence, Careggi, Florence, Italy.
Acta Ophthalmol. 2019 Dec;97(8):821-823. doi: 10.1111/aos.14109. Epub 2019 Apr 6.
To describe a surgical technique, using a human amniotic membrane (hAM) plug, in two cases of retinal detachment with a large macular tear.
Surgical technique description with surgical video. A 23-gauge pars plana vitrectomy with peripheral retinectomy was performed. An hAM plug was implanted under the neuroretina to seal the posterior retinal break. Standard silicone oil tamponade was performed at the end of the surgery. The patients were positioned face down after the operation for the first 2 weeks. Optical coherence tomography (OCT) scans were performed in the follow-ups.
The 1 week postoperative OCT showed a neuroretina ingrowth over the hAM plug. The 3-month OCT showed a regenerated neurosensory retina entirely covering the hAM plug. Visual acuity improved from light perception to 20/400 (LogMAR 1,3) 3 months after the operation in both patients. The silicone oil was extracted 4 months after surgery, and no recurrences were observed. The patients' visual acuity remained stable at 20/400 after the silicone oil extraction.
In these complex cases, hAM transplantation can be a valid option not only to help the retinal reattachment but also for a partial regenerative effect which, in these cases, was accompanied by a visual acuity recovery.
描述一种使用人羊膜（hAM）塞的手术技术，用于治疗 2 例伴有大黄斑裂孔的视网膜脱离。
手术技术描述结合手术视频。进行 23 号经睫状体平坦部玻璃体切割术联合周边视网膜切除术。将 hAM 塞植入神经视网膜下，以封闭后视网膜裂孔。手术结束时行标准硅油眼内填充。术后前 2 周患者保持面朝下体位。在随访中进行光学相干断层扫描（OCT）检查。
术后 1 周的 OCT 显示 hAM 塞上神经视网膜向内生长。术后 3 个月的 OCT 显示再生的神经感觉层完全覆盖 hAM 塞。2 例患者的视力均从光感提高至术后 3 个月的 20/400（LogMAR 1.3）。术后 4 个月取出硅油，未观察到复发。硅油取出后，患者的视力仍稳定在 20/400。
在这些复杂病例中，hAM 移植不仅有助于视网膜复位，还可能产生部分再生效果，在这些情况下，视力得到恢复。
