EFFICACY OF SPLIT-THICKNESS THIN AMNIOTIC MEMBRANE GRAFT FOR CLOSURE OF REFRACTORY OR LARGE MACULAR HOLES.

Abstract

To assess the effectiveness of split-thickness amniotic membrane grafts in achieving closure of refractory or large macular holes (MH). This retrospective study reviewed data from patients who underwent surgical repair of MHs using split-thickness amniotic membrane grafts between January 2019 and December 2023. Key parameters, including best-corrected visual acuity and MH size, were evaluated both preoperatively and postoperatively. The study included 13 patients (nine females; mean age 63.5 years). Before surgery, the median best-corrected visual acuity was 1.30 ± 0.56 logarithmic measure of angle of resolution (approximate Snellen equivalent: 20/400) and the median MH size measured 717 ± 246.6 µ m. After an average follow-up period of 28 months, the median best-corrected visual acuity improved significantly to 1.00 ± 0.52 logarithmic measure of angle of resolution ( P < 0.05) (approximate Snellen equivalent: 20/200). All MHs were successfully closed, and no intraoperative complications were observed. Split-thickness amniotic membrane grafting is a safe and reliable option for closing refractory or large MHs, resulting in significant improvements in best-corrected visual acuity and successful hole closure. Compared with full-thickness grafts, split-thickness amniotic membrane grafts offer advantages such as increased flexibility in placement and ease of removal post-closure, due to their thinner and more pliable nature, which facilitates easier handling and positioning within the MH.