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

Purpose: 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. Methods: 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. Results: 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. Conclusions: 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.