CENTRAL POSTERIOR LENS CAPSULE USED INSTEAD OF AN INVERTED INTERNAL LIMITING MEMBRANE FLAP: A CLINIC-PATHOLOGICAL CASE REPORT

Retin Cases Brief Rep. 2022 Sep 1;16(5):601-605. doi: 10.1097/ICB.0000000000001030.

Abstract

Purpose: To present immunocytochemical characterization of a surgically excised central posterior lens capsule (PLC) that was transplanted to close a secondary refractory full-thickness macular hole (FTMH) as an epiretinal flap. For comparison, tissue of both an unaffected internal limiting membrane and unexposed PLC was processed.

Methods: Clinical-pathological case report.

Results: We report of a 38-year-old patient who underwent pars plana vitrectomy (PPV) with PLC tissue for patching secondary FTMH and silicone oil tamponade after tractional retinal detachment. The PLC was peeled off during a vitrectomy 1 year after positioning. For immunocytochemistry, the removed PLC was prepared as flat mount and showed a positive immunofluorescence of the Müller cells marker glutamine synthetase and for vimentin. The microglia marker IBA and the neuroprotective neurotrophic marker glia cell-derived neurotrophic factor were tested positive too. There was no immunoreactivity of cellular retinaldehyde-binding protein and glial fibrillary acidic protein. In comparison, tissue of a control internal limiting membrane that was obtained during standard FTMH surgery showed few single cells that were likewise positive for glutamine synthetase, glia cell-derived neurotrophic factor, and IBA. The control specimen of unexposed PLC showed rarely cells that were without positive immunostaining for the tested markers.

Conclusion: Our analysis revealed positive immunoreactivity of macroglia and microglia cells of the PLC tissue that was used to patch a refractory FTMH. Similar immunostaining of PLC material and internal limiting membrane suggests the PLC transplantation as an alternative treatment option for refractory FTMH.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Basement Membrane / surgery
  • Epiretinal Membrane* / surgery
  • Glutamate-Ammonia Ligase
  • Humans
  • Nerve Growth Factors
  • Retinal Perforations* / surgery
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity
  • Vitrectomy

Substances

  • Nerve Growth Factors
  • Glutamate-Ammonia Ligase