Long-term Structural and Functional Outcomes after Autologous Retinal Transplant Surgery for Complex Macular Hole

Abstract BACKGROUND Vitrectomy and internal limiting membrane peeling has been the Gold Standard for macular hole treatment since the 90s with high closure rates for idiopathic macular holes, however those larger than 400 um or from other etiologies didn’t have such good outcomes. Over the years, different techniques were developed to increase anatomical and functional success rates, most of them using scaffold tissues; autologous retinal graft showed promising results in these cases, achieving higher closure rates and visual acuity improvement. SUBJECTS AND METHODS Observational prospective case series. 6 eyes treated with autologous retinal graft for complex macular holes were included. Baseline best corrected visual acuity (BCVA) and ocular coherence tomography (OCT) were collected. After 12 months of surgery, in all cases a complete ophthalmological examination, OCT, microperimetry, color vision and contrast sensitivity tests were performed at last follow-up. RESULTS 6 eyes were included with a minimal diameter of 781.7 ± 157.4 um. Initial BCVA was 0.8 ± 0.1 logMAR; all eyes showed improvement or stability: 0.7 ± 0.2 (p: 0.455) at 12-months, that remained stable in most cases at the end of follow-up (p: 0.30), reaching an 83% anatomical and 67% functional success rates. Color vision tests were normal in most of the eyes with a mild tritanopia in one case, regarding contrast sensitivity 5 eyes showed improvement. Microperimetry show some generalized sensitivity loss and residual microescotomas, and fixation stability was variable. CONCLUSIONS Autologous retinal graft is an efficient technique for complex macular hole repair with good functional and anatomical outcomes.