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Prognostic Factors in Patients with Persistent Full-Thickness Idiopathic Macular Holes Treated with Re-Vitrectomy with Autologous Platelet Concentrate.
Degenhardt, Valentin; Busch, Catharina; Jochmann, Claudia; Meier, Petra; Unterlauft, Jan Darius; Mößner, Andreas; Edel, Elvira; Tewari, Ruchir; Wiedemann, Peter; Rehak, Matus.
Affiliation
  • Degenhardt V; Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
  • Busch C; Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany.
  • Jochmann C; Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
  • Meier P; Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
  • Unterlauft JD; Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
  • Mößner A; Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
  • Edel E; Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
  • Tewari R; Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany.
  • Wiedemann P; Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.
  • Rehak M; Tewari Eye Centre, Ghaziabad, India.
Ophthalmologica ; 242(4): 214-221, 2019.
Article in En | MEDLINE | ID: mdl-31509827
PURPOSE: To identify the predictors for anatomical and functional outcome after re-vitrectomy with application of autologous platelet concentrate (APC) in eyes with persistent idiopathic macular hole (MH). METHODS: Retrospective study of 103 eyes with persistent MHs after vitrectomy with peeling of internal limiting membrane (ILM) and expansive gas. All patients underwent re-vitrectomy with APC and endotamponade. The anatomical MH closure rate and postoperative best-corrected visual acuity (BCVA) were evaluated. Further, predictive factors influencing the success of the surgery were analyzed. RESULTS: Median BCVA (logMAR) before the surgery was 1.00 (interquartile range [IQR] 0.80-1.30) and the median of minimum diameter between hole edges was 508 µm (IQR 387-631). The final closure rate after re-vitrectomy with APC was 60.2% (62 of 103 eyes). The following predictors were identified to significantly influence the closure rate: tractional hole index (THI), axial length, time between first and second surgery, and the experience of the surgeon (p < 0.05). CONCLUSIONS: Re-vitrectomy with APC led to the closure of 60.2% of the persistent MHs. The closure rate negatively correlates with increasing axial length, time between the first and second surgery, and the decreased THI. Further, experienced surgeons (with a history of >100 pars plana vitrectomies with ILM peeling) had significantly higher closure rates.
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Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_biologicas / Hemoterapia Main subject: Retinal Perforations / Vitrectomy / Blood Platelets / Blood Transfusion, Autologous / Visual Acuity / Endotamponade / Macula Lutea Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Ophthalmologica Year: 2019 Type: Article Affiliation country: Germany

Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_biologicas / Hemoterapia Main subject: Retinal Perforations / Vitrectomy / Blood Platelets / Blood Transfusion, Autologous / Visual Acuity / Endotamponade / Macula Lutea Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Ophthalmologica Year: 2019 Type: Article Affiliation country: Germany