Blood clump-assisted vitrectomy and internal limiting membrane peeling for macular hole repair

Retina. 2011 Nov;31(10):2014-20. doi: 10.1097/IAE.0b013e31821504a5.

Abstract

Purpose: To evaluate the efficacy and safety of using diluted autologous blood clumps to assist in vitrectomy and internal limiting membrane (ILM) peeling for macular hole (MH) repair.

Methods: Twenty-six patients with MHs who underwent ILM peeling were enrolled. The blood clump solution was prepared by mixing autologous whole blood with 5% glucose water. This solution was introduced to identify the posterior vitreous and was then used to coat the surface of the ILM in the macular area. The blood clump-coated ILM was removed with forceps in a circular fashion. The MH closure rate, the pre- and postoperative best-corrected visual acuity change, and retinal changes were evaluated.

Results: The blood clump-assisted procedure effectively labeled the posterior vitreous and coated the ILM, enhancing the visibility of ILM and, thus, facilitating MH repair. The MHs were closed by a single surgery in 24 eyes (92%), and the other 2 holes were closed after a second gas-fluid exchange. The pre- and postoperative mean best-corrected visual acuities were 0.96 ± 0.3 and 0.38 ± 0.3 (logarithm of the minimum angle of resolution visual acuity ± SD, P < 0.001), respectively. No toxic fundus changes were observed during the follow-up period.

Conclusion: This novel blood clump-assisted procedure effectively labeled the posterior vitreous and coated the ILM, enhancing the visibility of ILM and thereby facilitating MH repair.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Basement Membrane / surgery*
  • Blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Retinal Perforations / physiopathology
  • Retinal Perforations / surgery*
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy / methods*