Inclusion criteria for the study/search included ART techniques descriptions for full-thickness MH, MH with/without retinal detachment, naïve MH cases, and MH refractory cases. Search keywords included “autologous”, “retinal transplant”, “autologous neurosensory retinal free flap” “transplantation”, “macular hole”, and “macular hole surgery”. The following databases were searched: Embase (1990–2020), MEDLINE and MEDLINE Non-Indexed Items, Ovid MEDLINE® (1990 to November 2020), Embase (1990 to November 2020), Ovid MEDLINE® and Epub Ahead of Print, in-Process and Web of Science (all years). This review aims to describe some technical variants, the anatomical and functional results of the case series of ART for MH published to date. Since its introduction, several other ART case reports and case series have been published for MH and other retinal diseases. Grewal and Mahmoud described the original ART technique. One of the most recently described techniques is autologous retinal transplantation (ART). Īutologous internal limiting membrane graft, autologous serum, blood, lens capsule, and amniotic membrane are some of the tissues used in MH surgery. Some of these techniques use transplanted tissue either from the patient’s eye or another donor, achieving the MH’s closure through various mechanisms. In the last decade, several other techniques have been described for the treatment of MH hole patients. However, in up to 10% of the operated cases, the MH closure is not achieved with conventional surgery. Peeling the internal limiting membrane is one of the modifications to the original MH surgery technique that has increased the MH closure rate. Since MH surgery’s original description, multiple variants to the original technique have been described. Wendel and Kelly published the first series of cases with idiopathic MH presence successfully treated with vitrectomy. In conclusion, the autologous retinal transplantation technique for macular hole patients has emerged as another surgical option, with a high macular hole closure rate and visual improvement. The presence of functionality in the graft area has also been documented by microperimetry and multifocal electroretinogram. The most frequently reported complications included considerable intraoperative bleeding and postoperative dislocation of the graft. Overall, the published case series of autologous retinal transplants have reported a macular hole closure rate of 66.7 to 100%, as well as a significant improvement in best-corrected visual acuity. The number of cases included in the different case series ranged from 2 to 130 cases, and prior macular hole surgeries of the patients ranged from 0 to 3. Indications of autologous retinal transplantation for macular hole surgery included refractory macular holes, conventional techniques, and large macular holes. Preoperative and final best-corrected visual acuity, microperimetry and multifocal electroretinogram findings, macular hole closure rate, preoperative and postoperative ellipsoid zone, and external limiting membrane defects were obtained and analyzed. Eighteen case series and single case reports were reviewed. The following databases were searched: Medline and Medline Non-Indexed Items, Embase (1990–2020), Ovid Medline® (1990 to November 2020), Embase (1990 to November 2020), Ovid Medline® and Epub Ahead of Print, in-Process and Web of Science (all years). We aim to review scientific literature concerning published studies on autologous retinal transplantation to treat macular hole patients.
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