COMBINED INTERNAL LIMITING MEMBRANE FLAP AND AUTOLOGOUS PLASMA CONCENTRATE TO CLOSE A LARGE TRAUMATIC MACULAR HOLE IN A PEDIATRIC PATIENT

Abstract

Purpose: To describe a case of a large, traumatic macular hole in a pediatric patient closed using an internal limiting membrane flap in combination with autologous plasma concentrate (APC).

Methods: Description of a surgical technique as performed in one patient.

Results: Successful macular hole closure and improvement in postoperative visual acuity were achieved in the patient in whom the technique was performed.

Conclusion: The combined use of APC with the internal limiting membrane flap is advantageous because the APC acts to hold the internal limiting membrane in proper position and promotes the proliferation of glial cells through the presence of growth factors. This technique may be particularly advantageous in chronic or recalcitrant holes particularly in the setting of trauma.

Figures

Figure:

Preoperative, intraoperative and postoperative OCT imaging of the traumatic macular hole closed with ILM flap and autologous platelet concentrate (APC). A) Preoperative OCT of large traumatic macular hole measuring 1390 um in inner diameter. B) Intraoperative still frame from MIOCT showing ILM flap (asterisk) positioned over the hole. C) Intraoperative still frame rom MIOCT showing APC (arrow) placed in and overlying the hole. D) Anatomical closure on OCT are post-operative month 3.