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Purpose:
To describe a case of successful treatment of a chronic macular hole with an amniotic membrane (AM) graft.
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Case Report:
A 51-year-old woman, highly myopic with 25 diopters in both eyes, had a history of a macular buckle in the left eye (LE) for recurrent macular hole with retinoschisis 20 years ago. Best Corrected Distance Visual Acuity (BCDVA) was 20/400 in the LE. Axial length was 34 mm. Without control for the last 10 years, the patient reported diminished visual quality in recent months. Examination revealed a large macular staphyloma partially counteracted by previous macular buckle and partial pigment epithelium atrophy. Optical coherence tomography (OCT) showed a full-thickness macular hole of 815 µm, with flat edges and macular indentation. The patient underwent a 23-gauge three-port vitrectomy, during which a 6 mm round AM patch was placed over the hole. Perfluorocarbon liquid (PFCL) was then injected, and platelet concentrate was added under the PFCL to adhere the patch. Finally, a 20% SF6 gas exchange was performed. Nine months after surgery, the hole remained closed on OCT and BCDVA improved to 20/100.
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Discussion:
An AM plug is an effective technique with a high macular hole (MH) closure rate, a low rate of complications, and final improvement in BCDVA.
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Conclusions:
We present a successful case of closure of a chronic macular hole with an AM graft.