REVIEW ARTICLE


Autologous Retinal Transplant for Macular Hole



Sergio E. Hernández Da Mota1, 2, *, Virgilio Morales-Cantón3, Sergio Rojas-Juárez4, Antonio López-Bolaños4, Abel Ramírez-Estudillo5, Lisette Béjar Macouzet1, 2
1 Ophthalmology Department, Universidad Michoacana, Morelia, Mexico
2 Retina Service, Clínica David, Unidad Oftalmológica BlvdGarcía de León 598-2, Colonia Nueva Chapultepec, CP 58280, Morelia, Michoacán, Mexico
3 Retina Service, Hospital “Dr. Luis Sánchez Bulnes ”, Asociación para Evitar la Ceguera en México, IAP, UNAM, Mexico City, Mexico
4 Retina Service, Instituto de Oftalmología, Fundación Conde de Valenciana, UNAM, Mexico City, Mexico
5 Retina Service, Hospital Oftalmológico de Nuestra Señora de la Luz, UNAM, Mexico City, Mexico


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Creative Commons License
© 2021 Da Mota et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Retina Service, Clínica David, Unidad Oftalmológica Blvd. García de León 598-2, Colonia Nueva Chapultepec, CP 58280, Morelia, Michoacán, Mexico; Tel: +52 (443) 5280401; E-mail: tolodamota@yahoo.com.mx.


Abstract

We aim to review scientific literature concerning published studies on autologous retinal transplantation to treat macular hole patients. The following databases were searched: Medline and Medline Non-Indexed Items, Embase (1990–2020), Ovid Medline® (1990 to November 2020), Embase (1990 to November 2020), Ovid Medline® and Epub Ahead of Print, in-Process and Web of Science (all years). Search keywords included “autologous”, “retinal transplant”, “autologous neurosensory retinal free flap” “transplantation”, “macular hole”, and “macular hole surgery”. Eighteen case series and single case reports were reviewed.

Preoperative and final best-corrected visual acuity, microperimetry and multifocal electroretinogram findings, macular hole closure rate, preoperative and postoperative ellipsoid zone, and external limiting membrane defects were obtained and analyzed. Indications of autologous retinal transplantation for macular hole surgery included refractory macular holes, conventional techniques, and large macular holes. The number of cases included in the different case series ranged from 2 to 130 cases, and prior macular hole surgeries of the patients ranged from 0 to 3. Overall, the published case series of autologous retinal transplants have reported a macular hole closure rate of 66.7 to 100%, as well as a significant improvement in best-corrected visual acuity. The most frequently reported complications included considerable intraoperative bleeding and postoperative dislocation of the graft. The presence of functionality in the graft area has also been documented by microperimetry and multifocal electroretinogram.

In conclusion, the autologous retinal transplantation technique for macular hole patients has emerged as another surgical option, with a high macular hole closure rate and visual improvement.

Keywords: Autologous retinal transplant, Macular surgery, Macular hole, OCT, Microperimetry, Retinal graft.