Macular hole surgery with PPV+ILM+Gas+ Endoret® in a sample of three patients with high myopia of more than 30 mm: surgery outcomes

Author: Miryam Ruiz (Spain)

Co-authors: Jaume Crespí, Clément Passabosc

Purpose

The success rate of pars plana vitrectomy (PPV) with peeling of internal limiting membrane (ILM) and gas in macular holes (MA) exceeds 90%. However, high myopia, especially that associated with an axial length greater than 30mm, is a poor prognostic factor, reducing the success rate to 50-60%. The introduction of the inverted flap technique of ILM for these cases has improved the efficiency of the surgery, however it is technically difficult. We evaluated the use of Endoret®, as a surgical alternative, which would facilitate the closure of the macular holes in these patients.

Setting/Venue

A case series follow-up of three patients treated with a new method of macular surgery. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Methods

We present three cases of macular hole on three patients with high myopia of more than 30 mm, they were treated with PPV, ILM peeling , gas and Endoret®. The Endoret® we used, was the plasma rich in growth factors (PRGF) liquid form , without using the membrane form.

Results

At eight months of follow-up, our patients kept the macular hole closed. The visual acuity had no changes in two of them (0.1) and only one had an improvement of one line (0.4 to 0.5). We achieved anatomical success in all the cases.

Conlusions

There are reports of the use of Endoret® with both of its forms together: membrane and PRGF liquid for macular holes, however the use of PRGF liquid alone had not been reported. The use of Endoret® in this modality, has shown a good anatomical result and could be considered as an alternative for complex cases of macular holes in patients with high myopia.

Financial Disclosure

None