Subretinal Implantation of a Human Amniotic Membrane Plug Prepared Using a Modified Corneal Punch Technique For The Treatment of Large Full-Thickness Macular Holes.

Abstract

To report a new technique using tailored corneal punches to prepare round human amniotic membrane (hAM) plugs for the treatment of large full-thickness macular holes (FTMHs). Eight eyes with large FTMHs (>650 µ m) in eight patients were included. Pars plana vitrectomy (23 G) was performed, and round hAM plugs were prepared from the hAM patch by using tailored corneal punches. The size of the hAM plug was chosen according to the size of the FTMH. Endotamponade was performed using 14% C 3 F 8 after subretinal implantation of the hAM plugs. The patients were followed up for ≥6 months. The mean FTMH size was 737.0 ± 86.2 µ m. All FTMHs (100%) were closed within the 6-month follow-up period. The best-corrected visual acuity (LogMAR, [Snellen]) improved significantly from 1.74 ± 0.30 (20/1,000) before surgery to 0.76 ± 0.32 (20/100) at 6 months after surgery ( P < 0.05). No iatrogenic injuries associated with the surgical procedure, rejection of the hAM plug, or parafoveal atrophy was observed throughout the 6-month follow-up. Subretinal implantation of hAM plugs prepared using tailored corneal punches was safe and effective for repairing large FTMHs. The procedures were successful and associated with promising visual acuity recovery.