A membrane crafted from remnants of the human amniotic sac can safely patch macular holes and retinal breaks, researchers reported today at Friday’s Retina Subspecialty Day.
Persistent macular holes are challenging to treat. Surgeons often resort to multiple surgeries, adjuvant drugs, or transplants. But these treatments can yield suboptimal visual outcomes.
A team led by Stanislao Rizzo, MD, said there’s a simpler—and safer—approach.
The surgeons took a cutaneous punch from the human amniotic sac, containing the epithelium, stroma, and chorion layer. They rounded the membrane’s margins, carved it into a precisely sized plug, and transplanted it into the macular hole’s subretinal space. The membrane is highly adhesive, they reported, and can be placed via a simple maneuver.
In a preliminary study of 10 rabbits, the membrane seamlessly and permanently repaired peripheral breaks and recurrent tears without stirring an inflammatory reaction.
Dr. Rizzo presented data from a complex case of a large macular hole after retinal detachment. Within 3 months of implanting the amniotic plug, the team observed “extraordinary” retinal regeneration. Two months after removing the silicone oil tamponade, they noticed retinal tissue overlapping the plug.
They further tested the plug in 12 additional patients. They found that it could resolve cases of macular hole due to high myopia without the need for a gas tamponade. The patients had an average BCVA of 20/800 before surgery, which improved to 20/70 after surgery.
“For the first time, we have resolved an interruption of the retinal tissue with a regenerative process, not a destructive action,” Dr. Rizzo said. —Anni Griswold
Financial disclosures. None
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