Dhami Eye Care Hospital, Ludhiana, Punjab, India.
Netralayam- The Superspeciality Eye Care Centre, Kolkata, West Bengal, India.
Indian J Ophthalmol. 2022 Oct;70(10):3610-3616. doi: 10.4103/ijo.IJO_743_22.
To evaluate the success rate of autologous retinal graft (ARG) for the closure of full-thickness macular holes (MHs) and compare the outcomes of three different techniques of harvesting the graft.
Clinic files of all patients who had undergone ARG for MH using intraocular scissors, membrane loop, or retinal punch to harvest retinal tissue were retrospectively reviewed. All patients were evaluated for MH closure, retinal reattachment, and visual improvement.
Twenty-two eyes of 22 patients were included. ARG was done for 16 eyes (72.7%) with failed, large persistent MH, and six eyes (27.3%) also underwent simultaneous repair of retinal detachment. The basal diameter of MH was 1103.67 ± 310.09 (range 650-1529) μm. Intraocular scissors were used in 10 eyes (45.5%), a membrane loop in five eyes (22.7%), and a retinal punch in seven eyes (31.8%). Silicone oil tamponade was used in seven (31.8%) eyes and gas in 15 (68.1%) eyes. The follow-up ranged from 6 to 18 months. The hole closure rate was 72.7% (16/22). Visual improvement was noted in 18 eyes (81.8%). Retinal reattachment was seen in all eyes. Good graft integration with the surrounding area was seen in 17 eyes (77.3%). Graft retraction was seen in four eyes (18.18%) and graft loss in one eye (4.55%). No significant differences were noted among the three groups.
ARG is successful in closing large, failed MH with and without retinal detachment. A membrane loop and retinal punch are equally useful in harvesting the graft, but scissors are preferable in case the retina is detached. With all three techniques, integration of the graft with the surrounding tissue can be achieved.
评估自体视网膜移植（ARG）封闭全层黄斑孔（MH）的成功率，并比较三种不同的移植片采集技术的结果。
回顾性分析所有采用眼内剪刀、膜环或视网膜穿刺器采集视网膜组织行 ARG 治疗 MH 的患者的临床资料。所有患者均评估 MH 闭合、视网膜复位和视力改善情况。
共纳入 22 例（22 只眼）患者。ARG 用于治疗 16 只（72.7%）眼既往失败的大持续性 MH 和 6 只（27.3%）眼合并视网膜脱离。MH 的基底直径为 1103.67±310.09μm（范围 650-1529μm）。10 只眼（45.5%）采用眼内剪刀、5 只眼（22.7%）采用膜环、7 只眼（31.8%）采用视网膜穿刺器。7 只眼（31.8%）眼硅油填充、15 只眼（68.1%）眼气体填充。随访 6-18 个月。16 只眼（72.7%）孔闭合。18 只眼（81.8%）视力改善。所有眼均视网膜复位。17 只眼（77.3%）移植片与周围区域良好整合。4 只眼（18.18%）出现移植片回缩，1 只眼（4.55%）出现移植片丢失。三组间无显著差异。
ARG 可成功封闭合并或不合并视网膜脱离的大、既往失败 MH。膜环和视网膜穿刺器采集移植片同样有效，但在视网膜脱离时，剪刀更可取。三种技术均能实现移植片与周围组织的整合。
