Anatomical and Functional Efficiency of a Modified Method of Autologous Retinal Transplantation for Large Full-thickness Macular Holes

Abstract

Purpose . To evaluate the anatomical and functional efficacy of a modified autologous retinal transplantation (ART) technique in the surgical treatment of large full-thickness macular holes (FTMH). Material and Methods . The study included 41 patients (42 eyes) with a minimum FTMH diameter greater than 800 µm who had previously undergone vitrectomy with internal limiting membrane peeling and gas tamponade due to FTHM. Patients were divided into two groups. In the main group, a modified ART was performed using preoperative navigated flap planning, intraoperative optical coherence tomography guidance, and fixation with autologous platelet-rich plasma. In the control group, macular hole edges were closed using an aspiration technique followed by application of autologous platelet-rich plasma. Anatomical outcomes were assessed by optical coherence tomography, while functional outcomes included bestcorrected visual acuity and central retinal sensitivity. The follow-up period was 6 months. Results . Stable anatomical closure of the FTMH was achieved in all cases in the main group. In the control group, macular hole recurrence was observed in 22 % of patients (p = 0.049). Both groups demonstrated a statistically significant improvement in best-corrected visual acuity and retinal sensitivity as early as 1 month postoperatively, with no significant intergroup differences in cases with successful anatomical closure. Conclusions . Modified ART provides a higher and more stable anatomical success rate in the treatment of large FTMH compared with the edge approximation technique. Functional outcomes are characterized by early improvement followed by stabilization during follow-up.