Anatomical and Functional Outcomes of Platelet-Rich Plasma-Assisted Surgery for Full-Thickness Macular Holes: A Retrospective Real-World Cohort Study

Abstract

Objectives: To describe short-term anatomical and visual outcomes after platelet-rich plasma (PRP)-assisted surgery for full-thickness macular holes (FTMHs) in a selected real-world cohort, predominantly consisting of previously operated and large holes. Methods: This retrospective, register-based cohort study included 61 eyes of 61 patients who underwent FTMH surgery with adjunctive autologous PRP. Anatomical closure, short-term BCVA change, and exploratory OCT associations were evaluated overall and by surgical subgroup. Results: Seven eyes underwent PRP-assisted primary surgery and 54 underwent repeat surgery. Complete closure occurred in 46/61 eyes (75.4%; 95% CI, 63.3–84.5%). Median BCVA improved from 0.74 to 0.53 logMAR (p < 0.001); results remained directionally consistent in a 21–42-day sensitivity window (n = 33; p = 0.016). Nine eyes underwent combined phaco-vitrectomy. Preoperative MLD differed across anatomical outcomes (p = 0.005), where the border-cyst association with postoperative BCVA was not significant after adjustment. Conclusions: PRP-assisted surgery was followed by substantial short-term anatomical closure and visual improvement, but the uncontrolled design, heterogeneous management, and incomplete characterization of prior surgery and PRP preclude attribution of efficacy or safety to PRP.