Long-Term Follow-Up of Refractory Large Macular Hole with Autologous Neurosensory Retinal Free Flap Transplantation

Po-Yen Lee; Yo-Chen Chang; Pei-Kang Liu; Tzu-En Kao; Horng-Jiun Wu; Kuo-Jen Chen; Kwou-Yeung Wu; Kai-Chun Cheng; Wen-Chuan Wu

doi:10.1155/2022/1717366

Long-Term Follow-Up of Refractory Large Macular Hole with Autologous Neurosensory Retinal Free Flap Transplantation

J Ophthalmol. 2022 May 9:2022:1717366. doi: 10.1155/2022/1717366. eCollection 2022.

Authors

Po-Yen Lee¹, Yo-Chen Chang^{1

2

3}, Pei-Kang Liu¹, Tzu-En Kao⁴, Horng-Jiun Wu¹, Kuo-Jen Chen⁵, Kwou-Yeung Wu^{1

3}, Kai-Chun Cheng^{1

3

5}, Wen-Chuan Wu^{1

4}

Affiliations

¹ Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
² Department of Ophthalmology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 80145, Taiwan.
³ Department of Ophthalmology, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
⁴ Department of Ophthalmology, Park One International Hospital, Kaohsiung 81357, Taiwan.
⁵ Department of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan.

Abstract

Purpose: To evaluate the long-term anatomic and functional outcomes of autologous neurosensory retinal free flap transplantation (ART) for patients with refractory large macular hole (MH).

Design: Retrospective interventional case series.

Methods: We reviewed 9 patients who underwent ART for their refractory large MH. In this extended follow-up study, postoperative assessment including spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) were recorded at 12, 15, 18, 21, and 24 months after surgery.

Results: The macular hole of all patients appeared successfully closed during the whole follow-up period. The mean logMAR BCVA improved from 1.61 ± 0.44 (preoperative) to 0.72 ± 0.30 (12 months after surgery) (p < 0.001). Thereafter, the mean BCVA remained stable at each follow-up. At the mean 16.0 ± 0.8 months postoperatively, inner retinal cystic changes were observed in 4 eyes (44.4%), but these did not significantly affect vision.

Conclusion: ART is a good alternative technique for closing large refractory macular holes. Although inner retinal cystic changes were observed in 4 eyes (44.4%), this phenomenon did not significantly affect visual acuity. It provides long-term good anatomical and functional results, especially in cases where insufficient ILM or lens capsule are left.