# Precut disc of lyophilized amniotic membrane for recurrent full thickness macular hole management

## TL;DR

This study shows that using a special dried amniotic membrane patch can effectively treat recurring macular holes in the eye, improving vision with minimal risk.

## Contribution

The study introduces a new method using lyophilized amniotic membrane precut discs for treating complex and recurrent macular holes.

## Key findings

- 85.2% of patients achieved anatomical closure of macular holes one month after surgery.
- Visual acuity improved significantly over 12 months post-surgery.
- No adverse events were recorded during follow-up.

## Abstract

To assess the efficacy of precut disc of lyophilized amniotic membrane (LAM) in the management of recurrent full thickness macular hole (FTMH), already treated with pars plana vitrectomy (PPV), internal limiting membrane peeling, and gas tamponade.

Twenty-seven eyes of 27 patients with recurrent FTMH were included in this retrospective study and treated with 25G PPV, LAM graft (Visio Amtrix, TBF, Mions, France) and 20% SF6 gas tamponade. Spectral domain optical coherence tomography (SD-OCT) was used to assess anatomic FTMH closure 1 month postoperatively. Best corrected visual acuity (BCVA) was measured preoperatively and 1, 3, 6 and 12 months after surgery.

Twelve eyes presented large idiopathic FTMHs, 12 showed large FTMH associated with high myopia and the remaining 3 had large FTMH and retinal detachment in highly myopic eyes. Mean minimum FTMH diameter at baseline was 782±341.17 μm and mean BCVA was 1.02±0.63 LogMAR. Postoperatively, anatomical FTMH closure was achieved in 23/27 (85.2%) eyes one month after the surgery. Mean BCVA progressively improved during the follow-up period, reaching 0.55±0.42 LogMAR (p = 0.04) at 12-months follow-up. No adverse events were registered during follow-up.

Results suggest that epiretinal graft of LAM precut discs is a safe and effective surgical procedure for large and recurrent FTMH treatment, leading to significant BCVA improvement.

The online version contains supplementary material available at 10.1007/s00417-025-06955-x.

Encouraging anatomical results have been reported by using human amniotic membrane (hAM) graft for treatment of recurrent idiopathic or complex full thickness macular hole (FTMH) in eyes with co-morbidities such as high myopia with or without retinal detachment.Recently, liophylized hAM (LAM) patches, showing physical, biological and structural properties equivalent to classical hAM, have become available for clinical use. LAM may be stored at room temperature for long periods without deterioration, and its transportation is easy and inexpensive contrary to hAM, stored by cryopreservation, a deep freezing facility, expensive and not always available.

Encouraging anatomical results have been reported by using human amniotic membrane (hAM) graft for treatment of recurrent idiopathic or complex full thickness macular hole (FTMH) in eyes with co-morbidities such as high myopia with or without retinal detachment.

Recently, liophylized hAM (LAM) patches, showing physical, biological and structural properties equivalent to classical hAM, have become available for clinical use. LAM may be stored at room temperature for long periods without deterioration, and its transportation is easy and inexpensive contrary to hAM, stored by cryopreservation, a deep freezing facility, expensive and not always available.

This study revealed that epiretinal graft of LAM precut discs resulted in an 85.2% rate of anatomical FTMH closure one month after the surgery and was associated with a significant mean best corrected visual acuity improvement at 12-months follow-up in large and recurrent cases.Our results disclosed that epiretinal graft of LAM precut discs is a safe and efficace surgical procedure for management of recurrent large FTMH in the idiopathic and complex cases.

This study revealed that epiretinal graft of LAM precut discs resulted in an 85.2% rate of anatomical FTMH closure one month after the surgery and was associated with a significant mean best corrected visual acuity improvement at 12-months follow-up in large and recurrent cases.

Our results disclosed that epiretinal graft of LAM precut discs is a safe and efficace surgical procedure for management of recurrent large FTMH in the idiopathic and complex cases.

The online version contains supplementary material available at 10.1007/s00417-025-06955-x.