JUN 01, 2021
AAO 2020 Video Program
Retina/Vitreous, Vitreoretinal Surgery
Purpose To present the role of platelet-rich plasma membrane (PRPm) in a challenging case of high myopic macular hole (MH) and associated retinal detachment. Methods Preparation protocol, surgical technique and clinical results were correlated in an academic video. Results A 72-year-old female patient with a spherical equivalent of −11.26 D, axial length of 29.03 mm and best corrected visual acuity of 20/200, presenting with large MH, dome-shape macula and retinal detachment. PRPm was prepared from autologous blood samples by centrifugation. Subsequently, CaCl2 was added to a final concentration of 20 mM in order to initiate platelet activation and membrane formation. Pars plana vitrectomy (PPV) with PRPm was indicated. The procedure was technically challenging. A postoperative OCT angiography confirmed the presence of PRPm plug inside the MH. Three months after, the retina remained attached and the MH was closed. Conclusions PPV with PRPm is an alternative therapeutic approach for surgical treatment of MH, even in those of difficult management, as with myopic origin.