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OCT scan of the right eye of a patient showing the preoperative macular hole measuring 1065 microns and the retinal detachment.
Source publication
Purpose
To evaluate the efficacy of human amniotic membrane in promoting closure of macular holes coexisting with rhegmatogenous retinal detachment.
Methods
This is a retrospective case series of 14 eyes (14 patients) with macula off retinal detachment. These patients had a macular hole coexistent with peripheral retinal breaks. A human amniotic m...
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Background:
The classification of macular hole closure patterns (MHCPs) currently relies on time domain OCT allowing only "open" and "closed" statuses or is based on inner foveal contour shape. Both classification types give no information on retinal layer reconstitution. Novel sophisticated surgical techniques lead to previously unknown MHCPs, ou...
Citations
... Долгое время золотым стандартом лечения сквозного макулярного разрыва считали витрэктомию, проведение пиллинга внутренней пограничной мембраны (ВПМ) с последующей тампонадой воздухом/газо-воздушной смесью [8]. С целью дополнительного повышения эффективности предложены модификации хирургического подхода в лечении макулярных разрывов: механическое сближение краев разрыва, проведение пилинга ВПМ с последующим закрытием разрыва инвертированным лоскутом ВПМ, амниотической мембраной, трансплантация передней капсулы хрусталика, сохранение ВПМ [9][10][11][12]. ...
Odnoj iz vedushchih vitreoretinal'nyh patologij, privodyashchih k znachitel'nomu uhudsheniyu zritel'nyh funkcij, yavlyaetsya makulyarnyj razryv. V poslednie gody v hirurgii makulyarnyh razryvov perspektivno ispol'zovanie autoplazmy krovi s povyshennym soderzhaniem trombocitov. No, nesmotrya na vysokij procent zakrytiya makulyarnyh razryvov (78–96%), na segodnyashnij den' aktual'nym voprosom ostaetsya razrabotka novyh tekhnologij, napravlennyh na vosstanovlenie mikroarhitektoniki foveolyarnoj oblasti i povysheniya zritel'nyh funkcij. Cel'yu issledovaniya bylo razrabotat' novuyu tekhnologiyu rekonstrukcii foveolyarnoj oblasti pri makulyarnyh razryvah s ispol'zovaniem autologichnoj kondicionirovannoj plazmy. V predstavlennuyu rabotu voshli 9 pacientov (10 glaz) s idiopaticheskim skvoznym makulyarnym razryvom, kotorym byla vypolnena standartnaya trekhportovaya 27G-vitrektomiya s primeneniem autologichnoj kondicionirovannoj plazmy po razrabotannoj tekhnologii. V rezul'tate hirurgicheskogo lecheniya predlagaemaya tekhnologiya pozvolyaet poluchit' vysokie kliniko-funkcional'nye rezul'taty, a takzhe obespechivaet optimal'nuyu i bolee upravlyaemuyu rekonstrukciyu mikroarhitektoniku fovea.
... На сегодняшний день единственным эффективным методом хирургического лечения регматогенной отслойки сетчатки, осложненной сквозным макулярным разрывом, позволяющим достичь высоких анатомических и функциональных результатов, принято считать трехпортовую витрэктомию через плоскую часть цилиарного тела с удалением задних слоев стекловидного тела, закрытием макулярного разрыва, блокированием периферических разрывов с последующей тампонадой витреальной полости заместителями стекловидного тела (силиконовое масло различной степени вязкости, газовоздушная смесь с длительным периодом рассасывания, стерильный воздух) [1,5,[7][8][9]. ...
... С целью повышения эффективности хирургического лечения макулярного разрыва, а именно увеличения процента анатомического блокирования макулярного разрыва и улучшения зрительных функций, предложены различные методики хирургического закрытия макулярного дефекта: механическое сближение краев разрыва, проведение пилинга внутренней пограничной мембраны (ВПМ), блокирование макулярного разрыва инвертированным лоскутом ВПМ в различных модификациях, амниотической мембраной, трансплантация передней капсулы хрусталика, сохранение ВПМ [1,[7][8][9][10][11]. ...
... По данным литературы, большинство представленных хирургических техник лечения комбинации данных патологий заканчиваются эндовитреальной тампонадой силиконовым маслом с последующим его удалением через 3-6 месяцев [1,7,8,11,16] или газо-воздушной смесью [5,17]. Однако силиконовое масло не обладает способностью плотно прижимать сетчатку заднего полюса глаза. ...
Regmatogennaya otslojka setchatki, oslozhnennaya makulyarnym razryvom, yavlyaetsya redkoj i naibolee trudnoj patologiej v plane vitreoretinal'noj hirurgii, a uspeshnyj anatomicheskij rezul'tat ne vsegda soprovozhdaetsya vysokimi zritel'nymi funkciyami. Na segodnyashnij den' naibolee effektivnym metodom hirurgicheskogo lecheniya dannoj patologii prinyato schitat' vitrektomiyu s zakrytiem makulyarnogo razryva autoplazmoj krovi s povyshennym soderzhaniem trombocitov, blokirovaniem perifericheskih razryvov i posleduyushchej tamponadoj vitreal'noj polosti zamestitelyami steklovidnogo tela. Pri vsej variativnosti hirurgicheskih podhodov k lecheniyu regmatogennoj otslojki setchatki, oslozhnennoj skvoznym makulyarnym razryvom, ostaetsya aktual'nym poisk bezopasnoj i effektivnoj hirurgicheskoj tekhnologii, pozvolyayushchej pri minimal'nom povrezhdenii retinal'nyh struktur dostich' vysokih morfo-funkcional'nyh rezul'tatov i minimizirovat' pri etom srok reabilitacii pacienta. Predstavlennyj klinicheskij sluchaj demonstriruet vozmozhnost' odnomomentnogo mikrohirurgicheskogo lecheniya regmatogennoj otslojki setchatki, oslozhnennoj skvoznym makulyarnym razryvom s primeneniem autologichnoj kondicionirovannoj plazmy v kombinacii s kratkovremennoj tamponadoj perftororganicheskim soedineniem. Rezul'taty ispol'zovaniya dannoj tekhnologii pokazali ee nadezhnost' i vysokuyu effektivnost', a takzhe obespechili vysokij morfo-funkcional'nyj rezul'tat v posleoperacionnom periode — vosstanovlenie makulyarnoj arhitektoniki, zakrytie makulyarnogo razryva, anatomicheskoe prileganie setchatki i uluchshenie zritel'nyh funkcij.
... Geological drilling and oil-gas development is gradually developing in depth. In the process of drilling, there are problems such as collapse, leakage, and reservoir pollution caused by borehole wall instability [95][96][97][98]. Drilling fluid film forming technology (adding film forming material to drilling fluid can generate permeable film or diaphragm on the surface of the plugging layer, preventing or reducing drilling fluid from entering the formation, preventing the formation from producing cracks, and maintaining wellbore stability) can effectively solve such problems, and so this technology has become a hotspot for research [98][99][100]. ...
Intelligent polymers have become the focus of attention worldwide. Intelligent polymer materials through organic synthesis methods are used to make inanimate organic materials become “feeling” and “sentient”. Intelligent polymer materials have been applied in actual engineering production, and they are becoming a new research topic for scientists in various fields and countries, especially in the areas of drilling and plugging. The development of intelligent polymer materials can provide new solutions and technical means for drilling and plugging. Unlike traditional plugging materials, intelligent polymer plugging materials can cope with environmental changes. They have the characteristics of a strong target, good plugging effect, and no damage to the reservoir. However, there are currently no reviews on intelligent polymer plugging materials in the drilling field, so this paper fills that gap by reviewing the research progress of intelligent polymer plugging materials. In addition, this paper describes the mechanism and application status of intelligent polymer shape-memory polymers, intelligent polymer gels, intelligent polymer membranes, and intelligent polymer bionic materials in drilling and plugging. It is also pointed out that some intelligent polymer plugging materials still have problems, such as insufficient toughness and a poor resistance to salt and high temperature. At the same time, some suggestions for future research directions are also presented for reference.
... Only 1 document reported a mild increase of intraocular pressure [18], suggesting that the amniotic membrane plug is a highly compatible intraocular graft. Also, there are some reports regarding hAM in initial MH surgery [34,35]. Abouhussein et al. achieved 100% MH closure rate in 14 patients using hAM without performing ILM peeling [34], indicating that hAM may help reduce sur-gical steps, but this requires larger sample size randomized controlled trials to verify. ...
... Also, there are some reports regarding hAM in initial MH surgery [34,35]. Abouhussein et al. achieved 100% MH closure rate in 14 patients using hAM without performing ILM peeling [34], indicating that hAM may help reduce sur-gical steps, but this requires larger sample size randomized controlled trials to verify. This review has several shortcomings. ...
Purpose:
The treatment of refractory macular holes is controversial, with human amniotic membrane grafts emerging recently as an attractive option. We performed a meta-analysis and systematic review in this paper to assess the results of human amniotic membrane (hAM) in the treatment of refractory macular hole (MH).
Methods:
We searched the Cochrane Database of Systematic Reviews, Web of Science, PubMed, Embase, China National Knowledge Infrastructure databases, VIP database, Wanfang Data Knowledge Service Platform, Sinomed, Chinese Clinical Trial Registry, and Clinical Trials.gov. Studies reporting hAM for the treatment of refractory MH were included. The outcomes are MH closure rate, visual acuity (VA) improvement rate, and graft dislocation/contracture rate.
Results:
A total of 8 studies on 103 eyes were included, all of which had undergone failed vitrectomy and internal limiting membrane (ILM) peeling. In all studies, the VA improvement rate was 66% (95%CI: 45 to 84%), the MH closure rate was 94% (95%CI: 84 to 100%) and the hAM graft dislocation/contracture rate was 6% (95%CI: 0 to 15%). In the studies using cryopreserved hAM grafts, the MH closure rate was 99% (95%CI: 94 to 100%) and the hAM graft dislocation/contracture rate was 3% (0%, 10%). The VA improvement rates were 94% (95%CI: 79 to 100%) in the retinal detachment subgroup, 37% (95%CI: 20 to 56%) in the pathologic myopia subgroup, and 62% (95%CI: 14 to 100%) in the idiopathic MH subgroup.
Conclusion:
Human amniotic membrane in the treatment of refractory MH results in visual improvement. It has a high macular hole closure rate and low dislocation/contracture rate. Cryopreserved hAM grafts might have better outcomes than dehydrated grafts.
... The retina was shown to adhere over the AM plug in the retinal break site at 1-week post-surgery when using optical coherence tomography analysis [71]. Similar to Rizzo et al. in 2019 study multiple papers have supported the use of AM plugs in conjunction with vitrectomy for the treatment of retinal detachment [70,79,80]. Abouhussein et al. in 2020 [79] reported 14 eyes of 14 patients all diagnosed with rhegmatogenous retinal detachment co-existing with a macular hole. ...
... Similar to Rizzo et al. in 2019 study multiple papers have supported the use of AM plugs in conjunction with vitrectomy for the treatment of retinal detachment [70,79,80]. Abouhussein et al. in 2020 [79] reported 14 eyes of 14 patients all diagnosed with rhegmatogenous retinal detachment co-existing with a macular hole. All the patients were treated with a human AM plug and had their condition improved from a BCVA of 1.87 ± 0.31 logMAR preoperatively to 0.67 ± 0.17 logMAR post-operatively at the 6-month follow-up [79]. ...
... Abouhussein et al. in 2020 [79] reported 14 eyes of 14 patients all diagnosed with rhegmatogenous retinal detachment co-existing with a macular hole. All the patients were treated with a human AM plug and had their condition improved from a BCVA of 1.87 ± 0.31 logMAR preoperatively to 0.67 ± 0.17 logMAR post-operatively at the 6-month follow-up [79]. All the patients noted complete retinal attachment and macular hole closure at the 6-month follow-up appointment. ...
The main reasons why Amniotic Membrane (AM) is transplanted in Ophthalmology are: to provide a substrate for cellular growth and to provide tectonic support or as a biological bandage and barrier that protects the wound to facilitate an environment for wound healing. The application of AM is well-documented in corneal disorders of various aetiologies [1], however, research within the field has highlighted how it can be used in conjunctival disorders and most recently, in glaucoma and vitreoretinal procedures. This review explores the preservation modalities of AM and summarises the current literature regarding AM transplantation in Glaucoma and Vitreoretinal conditions. AM transplantation in conjunction with trabeculectomy was reported to be used in two different surgical techniques. They differ in relation to the position of the implant: below the scleral flap or over the entire exposed sclera. The results of these studies suggest that AM transplant is a safe procedure that helps in the improvement of the intraocular pressure when associated with trabeculectomies. Moreover, it enhances trabeculectomies success rates when used along with mitomycin C [2]. The use of AM is also described for managing leaking blebs. It is mentioned to be a suitable alternative to conjunctival advancement. Regarding AM transplantation in glaucoma shunt or valve surgeries, the current literature is relatively limited. However, AM has been described as a good tectonic support for shunt procedures [3]. Successful results are described in the literature for surgical treatments using AM plug for vitreoretinal procedures. In particular macular hole closure and rhegmatogenous retinal detachment. In conclusion, AM transplant is a very promising and versatile adjutant therapy. However, further studies are also required for a better understanding and refinement of surgical techniques.
... In 2018, Rizzo and colleagues proposed a novel technique using a hAM to close recurrent MHs [32]. Afterwards, the hAM was adapted for MHRD in highly myopic eyes, with encouraging results [33][34][35][36]. The use of hAMs in retinal pathologies has already shown anti-inflammatory, antiangiogenic, and neurotrophic properties both on the retinal pigment epithelium (RPE) and the retinal external layers at the margin of MHs. ...
... Abouhussein et al. [36], after treating 14 high myopic eyes with MHRD with hAM transplant, obtained 100% MH closure and retinal reattachment with BCVA improvements from 1.87 to 0.67 logMAR. ...
PurposeTo determine the efficacy of using a human amniotic membrane to close macular hole retinal detachment in highly myopic eyes.Study designProspective, consecutive, nonrandomized interventional study.Methods
We included 19 high myopic eyes from 19 patients affected by macular hole retinal detachment who had already undergone vitrectomy with internal limiting membrane peeling. The patients underwent vitrectomy with amniotic membrane transplant.ResultsPrimary success was achieved after 3 months in 89.5% (17 of 19 eyes) and final macular hole closure was obtained in 94.7% (18 of 19 eyes) of the patients. The final retinal reattachment rate was 100%. The final 12-month mean BCVA improved from 20/2000 (2 logMAR) to 20/250 (1.1 logMAR). OCT-angiography revealed a high correlation between the superficial and deep capillary plexus and the final BCVA.Conclusion
Human amniotic membrane patches can effectively repair macular hole retinal detachment in high myopic eyes in terms of anatomic results and BCVA recovery.
... At the same time, Abohussein et al. [12] presented a retrospective case series of 14 eyes (14 patients) with macula of retinal detachment. These patients had a macular hole coexistent with peripheral retinal breaks. ...
Objective: The aim of this study was to determine the efficacy of hAM plug in the treatment of idiopathic macular hole and to see its post-operative visual improvement and anatomical apposition.
Material and methods: 10 eyes of 10 patients who had idiopathic MH underwent a pars plana vitrectomy (PPV) with the hAM plug implanted in MH. The patients were followed up on 2nd day, 1st week, 3rd week, 6th week and 3rd month.
Results: Final anatomical closure of MH was achieved in all the cases. BCVA improved from 0.91±0.11 logMAR to 0.28±0.06 logMAR after 3 months. No adverse event was documented in the specified period.
Conclusion: hAM plug is an efficient method to treat and manage idiopathic MH with encouraging results both in terms of anatomical closure and visual acuity gain.
Abbreviations: MH = Macular Hole, IOP = Intra Ocular Pressure, ILM = Internal Limiting Membrane, BCVA = Best Corrected Visual Acuity, OCT = Optical Coherence Tomography, LogMAR = Logarithm of Minimum Angle of Resolution, hAM = Human Amniotic Membrane, RPE = Retinal Pigment Epithelium
... However, the MH closure rate varied greatly from 31% to 100%. [1][2][3]5,9,10,13,[18][19][20][21] Although most patients undergo ILM peeling during the initial surgery, the role of ILM peeling remains controversial. Internal limiting membrane peeling in MH is primarily aimed to improve the surgical outcomes by removing any remaining tractional forces across the macular area. ...
Purpose:
To report the clinical features and treatment outcomes of patients with macular hole (MH) coexistent with rhegmatogenous retinal detachment (RRD) surgically treated with pars plana vitrectomy (PPV) and inverted internal limiting membrane (ILM) flap technique.
Methods:
We retrospectively evaluated 11 consecutive patients with RRD and macular hole who underwent vitrectomy and ILM-peeling with the inverted flap technique between December 2017 and February 2021. The main outcome measures were retinal reattachment rate, macular hole closure rate, and postoperative best-corrected visual acuity (BCVA). A non-systematic literature review was performed to compare our outcomes with those previously reported.
Results:
The primary retinal reattachment rate was 90% (10/11) with one surgery and 100% with two surgical procedures. Macular hole closure was achieved in all patients (11/11). All patients showed an improvement in visual acuity at the final postoperative visit, and the mean postoperative BCVA was 0.60±0.32 logMAR (20/80 Snellen equivalent).
Conclusion:
Vitrectomy with the inverted ILM-flap technique achieved favorable anatomical retinal reattachment rates but also an encouraging recovery of central macular anatomy and visual function in patients with macular hole coexistent with rhegmatogenous retinal detachment.
... Trials and debates are still ongoing regarding whether to perform internal limiting membrane (ILM) peeling, combining scleral buckling with PPV, and using an exogenous extraocular tissue such as the amniotic membrane lens capsular ap to close the hole. [9,10] Although there are lots of different studies on this subject in the literature, the effect of tamponade has not been evaluated so far. Our study reported the surgical outcomes and tried to observe how intraocular tamponade affects these complex cases' anatomical and functional results. ...
Purpose
To introduce the surgical results and examine the effect of intraocular tamponades on surgical outcomes in patients with coexisting macular hole (MH) and rhegmatogenous retinal detachment (RRD) without high myopia.
Methods
This retrospective, cross-sectional, the two-center study was carried out with 29 eyes of 29 patients. The patients were divided into two groups according to the intraocular tamponade used in surgery: silicone oil (group 1) and C3F8 gas (group 2). In all patients, the internal limiting membrane was peeled during surgery. Exclusion criteria were determined as RRD with MH due to high myopia without peripheral retinal tears and traumatic MH.
Results
In group 1, preoperative best-corrected visual acuity (BCVA) was three logMAR, while postoperative BCVA was 1 logMAR (p < 0.001). In group 2, preoperative BCVA was 3 logMAR, while postoperative BCVA was 0.76 logMAR (p = 0.008). The retinal attachment success rate was 15/17 (89.3%) in group 1, 11/12 (91.7%) in group 2 (p = 0.64). MH closure rate was 12/17 (71.6%) in group 1, 10/12 (78.1%) in group 2 (p = 0.52). Besides, there was not any difference in terms of preoperative and postoperative BCVA, preoperative and postoperative intraocular pressure, BCVA improvement in both groups. (p = 0.77, p = 0.16, p = 0.63, p = 0.54, p = 0.21, respectively).
Conclusions
Our results showed no significant difference between using silicone oil or C3F8 gas as an intraocular tamponade after internal limiting membrane peeling in patients with RRD due to peripheral tear coexist MH.
... T. Garcin Ophthalmology Department, University Hospital, Saint-É tienne, France Different techniques using cryopreserved AM (cAM), a widely available tissue, have provided encouraging results either used first as a plug transplanted into the subretinal space [2][3][4][5][6] or placed secondly in an epiretinal position [7]. Rizzo et al. [2][3][4] used cAM from a local eye bank (Lucca, Italy) and positioned the plug with ''chorion down'', facing the retinal pigment epithelium (RPE) (i.e., as an inlay [8]). ...
... Rizzo et al. [2][3][4] used cAM from a local eye bank (Lucca, Italy) and positioned the plug with ''chorion down'', facing the retinal pigment epithelium (RPE) (i.e., as an inlay [8]). Abouhussein et al. [5] used homemade cAM and Huang et al. ...
