Yuguchi Takaaki, Ogura Shuntaro, Hirano Yoshio, Suzuki Norihiro, Yasukawa Tsutomu, Ogura Yuichiro
Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan .
Retin Cases Brief Rep. 2023 Mar 1;17(2):85-88. doi: 10.1097/ICB.0000000000001128.
To report a case of refractory macular hole (MH) in pseudophakic eye treated with autologous posterior capsule flaps transplantation.
Case report.
A 48-year-old man visited our hospital with visual loss in the right eye because of unclosed MH. The patient had undergone two previous surgeries in another hospital, that is, the first included a cataract surgery, vitrectomy, and internal limiting membrane peeling with sulfur hexafluoride (SF 6 ) gas tamponade, and the second included an ineffective autologous internal limiting membrane flap technique and massaging the edges of the MH with a soft-tipped flute needle followed by the same gas, but the MH remained open. In our hospital, posterior capsule flaps were acquired from the same eye, inserted into the MH, and the same gas tamponade was performed, which was about four months after the disease onset (3 months after the prior second surgery). The patient kept face-down position for a week after the surgery and the MH was closed, which remained for over 12 months. The visual acuity improved from 20/250 to 20/60, and the retinal sensitivities around the MH gradually improved.
An autologous posterior capsule flaps transplantation was effective in the management of refractory MH to not only close the MH but also improve the visual outcomes.
报告1例采用自体后囊瓣移植治疗的假晶状体眼难治性黄斑裂孔（MH）病例。
病例报告。
一名48岁男性因右眼MH未闭合导致视力下降前来我院就诊。该患者此前在另一家医院接受过两次手术，第一次包括白内障手术、玻璃体切除术、内界膜剥除及六氟化硫（SF6）气体填塞，第二次包括无效的自体内界膜瓣技术，并用软头笛针按摩MH边缘，随后采用相同气体填塞，但MH仍未闭合。在我院，从同一只眼中获取后囊瓣，植入MH，并进行相同的气体填塞，这是在疾病发作后约4个月（上次第二次手术后3个月）进行的。患者术后保持俯卧位一周，MH闭合，且持续超过12个月。视力从20/250提高到20/60，MH周围的视网膜敏感度逐渐提高。
自体后囊瓣移植在难治性MH的治疗中有效，不仅能闭合MH，还能改善视觉效果。
