Lee Po-Yen, Chang Yo-Chen, Liu Pei-Kang, Kao Tzu-En, Wu Horng-Jiun, Chen Kuo-Jen, Wu Kwou-Yeung, Cheng Kai-Chun, Wu Wen-Chuan
Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
Department of Ophthalmology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 80145, Taiwan.
J Ophthalmol. 2022 May 9;2022:1717366. doi: 10.1155/2022/1717366. eCollection 2022.
To evaluate the long-term anatomic and functional outcomes of autologous neurosensory retinal free flap transplantation (ART) for patients with refractory large macular hole (MH).
Retrospective interventional case series.
We reviewed 9 patients who underwent ART for their refractory large MH. In this extended follow-up study, postoperative assessment including spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) were recorded at 12, 15, 18, 21, and 24 months after surgery.
The macular hole of all patients appeared successfully closed during the whole follow-up period. The mean logMAR BCVA improved from 1.61 ± 0.44 (preoperative) to 0.72 ± 0.30 (12 months after surgery) ( < 0.001). Thereafter, the mean BCVA remained stable at each follow-up. At the mean 16.0 ± 0.8 months postoperatively, inner retinal cystic changes were observed in 4 eyes (44.4%), but these did not significantly affect vision.
ART is a good alternative technique for closing large refractory macular holes. Although inner retinal cystic changes were observed in 4 eyes (44.4%), this phenomenon did not significantly affect visual acuity. It provides long-term good anatomical and functional results, especially in cases where insufficient ILM or lens capsule are left.
评估自体神经感觉视网膜游离皮瓣移植术（ART）治疗难治性大黄斑裂孔（MH）患者的长期解剖和功能结果。
回顾性干预病例系列。
我们回顾了9例行ART治疗难治性大MH的患者。在这项延长随访研究中，记录术后12、15、18、21和24个月的评估结果，包括频域光学相干断层扫描和最佳矫正视力（BCVA）。
在整个随访期间，所有患者的黄斑裂孔均成功闭合。平均logMAR BCVA从术前的1.61±0.44提高到术后12个月的0.72±0.30（P<0.001）。此后，每次随访时平均BCVA保持稳定。术后平均16.0±0.8个月时，4只眼（44.4%）观察到视网膜内层囊性改变，但这些改变未显著影响视力。
ART是闭合难治性大黄斑裂孔的一种良好替代技术。尽管4只眼（44.4%）观察到视网膜内层囊性改变，但这种现象未显著影响视力。它提供了长期良好的解剖和功能结果，尤其是在残留内界膜（ILM）或晶状体囊不足的情况下。
