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Surgical treatment of large macular holes with bacterial collagenase and plated reach plasma

Author: Irina Makarenko (Russian Federation)

Co-authors: Pavel Lyskin

Purpose

To study the possibility of treating large macular hole (MH) with bacterial collagenase and plated reach plasma.

Setting/Venue

S.N. FEDOROV NMRC "MNTK "EYE MICROSURGERY"

Methods

25 patients with MH were examined and treated. Diameter of macular hole was from 400 to 850 µm. The BCVA before surgery ranged from 0.03 to 0.1. The result of treatment was evaluated by ВСVA, OCT and microperimetry. The follow-up period was 12 months after surgical treatment. Surgical technique. 25G pars plana vitrectomy, fluid-to-air replacement, application of bacterial collagenase solution to the macula, application with platelet-rich blood plasma to the MH, final tamponade with gas at MH diameter from 400 µm to 650 µm or silicone at MH diameter more than 650.

Results

In all cases MH closure was achieved. Silicone was removed in 1 to 3 months. In 3 months after the operation, BCVA was 0.2 to 1.0. In all cases, anatomical repair of the macular profile was achieved. There was no decrease of retinal sensitivity according to microperimetry during 1, 3, 6 and 12 months after surgery. There was no retinal nerve fiber layers damage like DONFL in 1, 3, 6 and 12 months after surgery.

Conlusions

Our results demonstrate the possibility of surgical treatment of large macular with bacterial collagenase and plated reach plasma. Excluding the ILM peeling reduces the risk of iatrogenic damage to the retina, as well as the decrease of the vision quality associated with DONFL.

Financial Disclosure

no financial relationship

Comments

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