Outcome of autologous platelet concentrate and gas tamponade compared to heavy silicone oil tamponade in persistent macular hole surgery

Schaub, Friederike ORCID: 0000-0003-2648-1626, Goezluegoel, Nasir, von Goscinski, Corinna, Enders, Philip, Heindl, Ludwig M. and Dahlke, Claudia . Outcome of autologous platelet concentrate and gas tamponade compared to heavy silicone oil tamponade in persistent macular hole surgery. Eur. J. Ophthalmol.. LONDON: SAGE PUBLICATIONS LTD. ISSN 1724-6016

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DOI:10.1177/1120672120903704

Abstract

Purpose: Persistence represents the major reason for failure of primary macular hole repair. A variety of surgical approaches are available for treating persistent macular holes. To compare clinical outcome of re-pars plana vitrectomy combined with autologous platelet concentrate and sulfur hexafluoride 20% gas tamponade with heavy silicone oil in persistent macular hole. Methods: Records of 48 consecutive eyes with persistent macular holes which underwent re-pars plana vitrectomy with either heavy silicone oil (35 eyes, persistent macular-hole minimum linear diameter: 518.8 +/- 171.1 mu m) or autologous platelet concentrate and sulfur hexafluoride 20% (13 eyes, persistent macular hole-minimum linear diameter: 454.1 +/- 211.3 mu m) were reviewed retrospectively. All patients underwent measurements of anatomical persistent macular hole characteristics evaluated by optical coherence tomography and visual function. Cases in which anatomical success failed after first re-pars plana vitrectomy were treated with the other surgical techniques, comparable to a cross-over design. Results: Persistent macular hole closure rate was 57.1% with autologous platelet concentrate and sulfur hexafluoride 20% and 45.7% with heavy silicone oil (p = 0.102). Functional results were comparable when persistent macular hole closure was achieved (p > 0.741), but significantly better for the autologous platelet concentrate with sulfur hexafluoride 20% group when persistent macular hole closure failed (p = 0.019). Conclusion: Re-pars plana vitrectomy combined with autologous platelet concentrate and sulfur hexafluoride 20% seems to achieve at least non-inferior persistent macular hole closure rates and comparable functional results when compared to heavy silicone oil, suggesting autologous platelet concentrate and sulfur hexafluoride 20% as a safe surgical alternative in persistent macular hole. Especially when persistent macular hole closure failed, autologous platelet concentrate with sulfur hexafluoride 20% seems to be superior regarding visual outcome.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Schaub, Friederike	UNSPECIFIED	orcid.org/0000-0003-2648-1626	UNSPECIFIED
Goezluegoel, Nasir	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
von Goscinski, Corinna	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Enders, Philip	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Heindl, Ludwig M.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Dahlke, Claudia	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED