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Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy

The aim of this study was to evaluate the long-time results of highly concentrated autologous platelet-rich plasma (PRP) used as an adjunct in lamellar macular hole (LMH) surgery. Nineteen eyes of nineteen patients with progressive LMH were enrolled in this interventional case series, on which 23/25...

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Autores principales: Hagenau, Felix, Osterode, Elisa V., Klaas, Julian E., Vogt, Denise, Keidel, Leonie F., Schworm, Benedikt, Siedlecki, Jakob, Mayer, Wolfgang J., Kreutzer, Thomas C., Priglinger, Siegfried G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10002568/
https://www.ncbi.nlm.nih.gov/pubmed/36902019
http://dx.doi.org/10.3390/ijms24054589
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author Hagenau, Felix
Osterode, Elisa V.
Klaas, Julian E.
Vogt, Denise
Keidel, Leonie F.
Schworm, Benedikt
Siedlecki, Jakob
Mayer, Wolfgang J.
Kreutzer, Thomas C.
Priglinger, Siegfried G.
author_facet Hagenau, Felix
Osterode, Elisa V.
Klaas, Julian E.
Vogt, Denise
Keidel, Leonie F.
Schworm, Benedikt
Siedlecki, Jakob
Mayer, Wolfgang J.
Kreutzer, Thomas C.
Priglinger, Siegfried G.
author_sort Hagenau, Felix
collection PubMed
description The aim of this study was to evaluate the long-time results of highly concentrated autologous platelet-rich plasma (PRP) used as an adjunct in lamellar macular hole (LMH) surgery. Nineteen eyes of nineteen patients with progressive LMH were enrolled in this interventional case series, on which 23/25-gauge pars plana vitrectomy was performed and 0.1 mL of highly concentrated autologous platelet-rich plasma was applied under air tamponade. Posterior vitreous detachment was induced, and the peeling of tractive epiretinal membranes, whenever present, was performed. In cases of phakic lens status, combined surgery was carried out. Postoperatively, all patients were instructed to remain in a supine position for the first two postoperative hours. Best-corrected visual acuity (BCVA) testing, microperimetry, and spectral domain optical coherence tomography (SD-OCT) were carried out preoperatively and at minimum 6 months (in median 12 months) postoperatively. Foveal configuration was postoperatively restored in 19 of 19 patients. Two patients who had not undergone ILM peeling showed a recurring defect at 6-month follow-up. Best-corrected visual acuity improved significantly from 0.29 ± 0.08 to 0.14 ± 0.13 logMAR (p = 0.028, Wilcoxon signed-rank test). Microperimetry remained unchanged (23.38 ± 2.53 preoperatively; 23.0 ± 2.49 dB postoperatively; p = 0.67). No patients experienced vision loss after surgery, and no significant intra- or postoperative complications were observed. Using PRP as an adjunct in macular hole surgery significantly improves morphological and functional outcomes. Additionally, it might be an effective prophylaxis to further progression and also the formation of a secondary full-thickness macular hole. The results of this study might contribute to a paradigm shift in macular hole surgery towards early intervention.
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spelling pubmed-100025682023-03-11 Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy Hagenau, Felix Osterode, Elisa V. Klaas, Julian E. Vogt, Denise Keidel, Leonie F. Schworm, Benedikt Siedlecki, Jakob Mayer, Wolfgang J. Kreutzer, Thomas C. Priglinger, Siegfried G. Int J Mol Sci Article The aim of this study was to evaluate the long-time results of highly concentrated autologous platelet-rich plasma (PRP) used as an adjunct in lamellar macular hole (LMH) surgery. Nineteen eyes of nineteen patients with progressive LMH were enrolled in this interventional case series, on which 23/25-gauge pars plana vitrectomy was performed and 0.1 mL of highly concentrated autologous platelet-rich plasma was applied under air tamponade. Posterior vitreous detachment was induced, and the peeling of tractive epiretinal membranes, whenever present, was performed. In cases of phakic lens status, combined surgery was carried out. Postoperatively, all patients were instructed to remain in a supine position for the first two postoperative hours. Best-corrected visual acuity (BCVA) testing, microperimetry, and spectral domain optical coherence tomography (SD-OCT) were carried out preoperatively and at minimum 6 months (in median 12 months) postoperatively. Foveal configuration was postoperatively restored in 19 of 19 patients. Two patients who had not undergone ILM peeling showed a recurring defect at 6-month follow-up. Best-corrected visual acuity improved significantly from 0.29 ± 0.08 to 0.14 ± 0.13 logMAR (p = 0.028, Wilcoxon signed-rank test). Microperimetry remained unchanged (23.38 ± 2.53 preoperatively; 23.0 ± 2.49 dB postoperatively; p = 0.67). No patients experienced vision loss after surgery, and no significant intra- or postoperative complications were observed. Using PRP as an adjunct in macular hole surgery significantly improves morphological and functional outcomes. Additionally, it might be an effective prophylaxis to further progression and also the formation of a secondary full-thickness macular hole. The results of this study might contribute to a paradigm shift in macular hole surgery towards early intervention. MDPI 2023-02-27 /pmc/articles/PMC10002568/ /pubmed/36902019 http://dx.doi.org/10.3390/ijms24054589 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hagenau, Felix
Osterode, Elisa V.
Klaas, Julian E.
Vogt, Denise
Keidel, Leonie F.
Schworm, Benedikt
Siedlecki, Jakob
Mayer, Wolfgang J.
Kreutzer, Thomas C.
Priglinger, Siegfried G.
Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy
title Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy
title_full Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy
title_fullStr Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy
title_full_unstemmed Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy
title_short Long-Term Results of Adjunct Autologous Platelet-Rich Plasma in Lamellar Macular Hole Surgery Showing Lasting Restoration of Foveal Anatomy
title_sort long-term results of adjunct autologous platelet-rich plasma in lamellar macular hole surgery showing lasting restoration of foveal anatomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10002568/
https://www.ncbi.nlm.nih.gov/pubmed/36902019
http://dx.doi.org/10.3390/ijms24054589
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