To compare anatomic and functional results, and to evaluate postoperatively the healing process in 3 different techniques for the closure of the refractory macular holes (MH).
The aim of the study is to evaluate the therapeutic efficacy of Hydrated Amniotic Membrane in promoting closure of refractory macular holes. The Hydrated Amniotic Membrane has been used in some cases as an adjunct in the macular holes closure and as a substrate for cell growth and improvement of visual acuity. Hydrated Amniotic Membrane is supposed to promote epithelialization and have anti-fibrotic, anti-inflammatory properties. In the present study, the patients who meet the inclusion criteria will be randomized and undergo pars plana vitrectomy surgery with peeling of the ILM and a fragment of the ILM itself or an amniotic membrane plug will be put in place. The patients included in the study will undergo a complete eye examination, including corrected Visual Acuity measurement (BCVA), performing the Optical Coherence Tomography (OCT) and/or microperimetry, multifocal electroretinogram (mfERG) in the pre-operative. Patients will undergo surgery after complementary exams and adequate pre-anesthetic evaluation. Patients will be evaluated on the 1st and 7th postoperative days and at 1, 3, and 6 months after surgery. The patient will undergo a complete eye examination and postoperative follow-up as described above, and during visits on the 1st and 7th day, and in the 1st, 3th and 6th month of the postoperative period, BCVA and OCT will be performed and/or the microperimetry, multifocal electroretinogram (mfERG) will be performed in the 1st, 3th and 6th postoperative month for evaluation and monitoring of anatomical and functional responses, respectively.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
80
Using Hydrated Amniotic Membrane plug with vitrectomy to try to close refractory macular hole
The ILM filling technique - Rossi et al show that ILM filling technique was more efficacious in closing full-thickness macular holes larger than 630μm, in which the free ILM after peeling is plug into the area of the macular hole
Peeling with complete removal of the internal limiting membrane within the vascular arch
Tianjin Medical University General Hospital
Tianjin, Tianjin Municipality, China
RECRUITINGRate of Anatomic closure
Rate of anatomic macular hole closure in the OCT at month 6
Time frame: Month 6 post operative
Reconstruction of the foveal layered retinal structure change
Change in the reconstruction of the foveal layered retinal structure by OCT at 1, 3, and 6 months
Time frame: Month 1, 3, 6 post-operative
amniotic membrane dislocation
conform amniotic membrane dislocation in the OCT and/or binocular indirect ophthalmoscope at day 1 and 7
Time frame: DAY 1,7 post operative
BCVA change
change in the BCVA at Preoperative,1, 3, and 6 months
Time frame: Time Frame: Preoperative,Month 1, 3, 6 post operative
Retinal capillary plexus density change
change in the retinal capillary plexus density with OCT-A at Preoperative,1, 3, and 6 months
Time frame: Preoperative,Month 1, 3, 6 post operative
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