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    Use of ART to Treat a Hole in the Papillomacular Bundle

    AAO 2022 Video Program
    Posterior Segment Trauma, Retina/Vitreous, Vitreoretinal Surgery

    This video describes the use of autologous retinal transplantation (ART) to repair a hole in the papillomacular bundle. A 17-year-old boy with previous globe rupture developed total retinal detachment (RD) and retinal dragging, with a small hole in the papillomacular bundle area. Vitrectomy with silicone oil injection (SOI) and an internal limiting membrane flap over the hole were done. A couple of months later, the patient came back with lower RD under silicone with proliferative vitreoretinopathy (PVR), retinal shortening, and reopening of the hole in the papillomacular bundle. Visual acuity (VA) was hand-motion/counting-fingers 10 cm. Reoperation was done under silicone oil with PVR dissection first; then a large retinal graft was taken from the detached lower retina without diathermy and gently dragged within the silicone oil, put over the hole, and pushed back over the retinal surface using perfluorocarbon. Next, retinectomy was performed to flatten the shortened retina, with endolaser and more SOI. Serial optical coherence tomography scans showed graft integration within the retinal layers, with gradual improvement of VA that reached 0.05 unaided after 1.5 years.

    Financial Disclosure: Dr. Mariam Al-Feky discloses no financial relationships.