Anatomical and Functional Outcomes of Human-Amniotic Membrane Graft in Refractory Macular Hole Cases

TL;DR

Human amniotic membrane grafts show promise in repairing difficult-to-treat macular holes, with successful closures and improved vision in most patients.

Contribution

Demonstrates the effectiveness of human amniotic membrane grafts in refractory macular hole cases where traditional methods fail.

Findings

Nine out of eleven eyes achieved successful macular hole closure with no recurrence during 6 months.

Best-corrected visual acuity improved significantly at 3 and 6 months post-surgery.

Abstract

Macular hole (MH) surgery generally has a high success rate, but finding anatomical plug for refractory cases remains challenging. The human amniotic membrane (hAM), with its anti-inflammatory and regenerative properties, has emerged as a potential option. This study aims to report the anatomical and functional outcomes of human amniotic membrane (hAM) graft as an intervention to repair refractory macular hole cases where wide internal limiting membrane (ILM) peeling was unsuccessful. A retrospective chart review was conducted at a single center, with the main outcomes being closure rate and postoperative BCVA at 6 months. Eleven eyes of 11 patients with refractory macular holes were identified and included in the study. Participants were predominantly males (72.73%) with a mean age of 49.27 years. Nine eyes achieved successful MH closure with a single intervention and showed no recurrence during the 6-month follow-up. Mean BCVA at 3 and 6 months improved significantly (p = 0.0207) from 1.747 ± 0.74 logMAR to 1.210 ± 0.51 logMAR and 0.939 ± 0.47 logMAR (range 2.079–0.301 logMAR). The use of human amniotic membrane (hAM) graft seems to be a viable and effective alternative for the treatment of refractory macular holes. However, further larger prospective controlled studies are necessary to confirm our results.

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