J Korean Ophthalmol Soc.  2024 Nov;65(11):716-723. 10.3341/jkos.2024.65.11.716.

Effects of Autologous Platelet Concentrate Injection on Persistent Macular Hole

• Kim D
• Lee SH
• Ra H

• KMID: 2560838
• DOI: http://doi.org/10.3341/jkos.2024.65.11.716

Abstract

Purpose
To evaluate the effects of secondary pars plana vitrectomy (PPV) with autologous platelet concentrate (APC) injection in patients with a persistent macular hole that failed to close after the primary surgery.
Methods
This study included 10 eyes of 10 patients who required secondary PPV and APC injection due to unsuccessful hole closure following primary macular hole surgery between February 2021 and July 2023. We measured the minimum and base diameters of the holes before primary and secondary PPV, respectively. Furthermore, we evaluated the anatomical closure of the holes and changes in best corrected visual acuity (BCVA) for 6 months following secondary PPV.
Results
The mean age of the 10 patients was 61.6 ± 9.5 years. Prior to the primary PPV, the mean BCVA (LogMAR) was 1.6 ± 0.7, the mean minimum diameter of the hole was 654.4 ± 98.9 μm, and the mean base diameter of the hole was 1,135.4 ± 276.5 μm. Prior to the secondary PPV with APC injection, the mean BCVA (LogMAR) was 1.3 ± 0.7, the mean minimum diameter of the hole was 666.8 ± 270.2 μm and the mean base diameter of the hole was 845.4 ± 292.4 μm. Following secondary surgery, all holes were successfully closed, the mean BCVA (LogMAR) was 0.9 ± 0.6 and the BCVA was significantly improved (p = 0.007).
Conclusions
PPV with APC injection can be an effective therapeutic option for persistent macular hole that failed to close following primary surgery both in terms of anatomical and functional outcomes.

Keyword

Autologous platelet concentrate, Macular hole surgery, Pars plana vitrectomy, Persistent macular hole