| Autologous Transplantation of Internal Limiting Membrane for the Treatment of Large Macular Hole. |
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Kyong Ho Kim, Jae Woo Jung, Sung Who Park, Ik Soo Byon, Ji Eun Lee |
1Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea. isbyon@naver.com
2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
3Department of Ophthalmology, Pusan National University Hospital, Busan, Korea.
4Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. |
| 큰 황반원공에서 시행한 내경계막 자가이식술 |
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김경호1,2⋅정재우1⋅박성후3⋅변익수1,2,4⋅이지은3,4 |
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양산부산대학교병원 안과학교실1, 양산부산대학교병원 의생명융합연구소2, 부산대학교병원 안과학교실3, 부산대학교 의학전문대학원 안과학교실4 |
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Received: 22 May 2015 • Revised: 5 August 2015 • Accepted: 25 September 2015 |
| Abstract |
PURPOSE
To evaluate the surgical outcome of autologous transplantation of internal limiting membrane (ILM) for the treatment of large macular hole. METHODS: Twenty-five gauge pars plana vitrectomy was performed for the treatment of patients with full thickness macular hole larger than 400 microm. ILM was stained using 0.025% brilliant blue G. ILM around the hole was circumferentially peeled as large as 2.5 disc diameter (DD) in size and then transplanted inside the hole. ILM was peeled out additionally approximately 1.5 DD in size. Fluid-air exchange and gas injection were performed. After surgery, the hole was scanned using spectral domain optical coherence tomography. RESULTS: A total of 5 eyes were included in the present study. The mean age was 65.0 +/- 11.8 years (52-77) and mean best corrected visual acuity (log MAR) was 0.80 +/- 0.27. The mean refractive error was -2.0 +/- 2.2 diopter, mean horizontal size of hole was 701.4 +/- 129.4 microm, mean vertical size was 630.2 +/- 202.8 microm, mean hole base size was 1,043.4 +/- 225.0 microm and hole height was 464.4 +/- 218.9 microm. At the first day after surgery, transplanted ILM was detected inside the hole in all 5 eyes and complete closure of the hole occurred in 4 eyes. One hole was closed between postoperative days 4 and 7. Foveal contour improved gradually but photoreceptor integrity did not during the follow-up period. Two eyes showed visual improvement but 3 did not after surgery. CONCLUSIONS: Macular hole was closed successfully and quickly using the autologous ILM transplantation technique. Based on our results, the autologous ILM should be considered the treatment of choice for large macular holes. |
| Key Words:
Autologous internal limiting membrane implantation;Macular hole |
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