J Korean Ophthalmol Soc.  2020 May;61(5):564-569. 10.3341/jkos.2020.61.5.564.

Autologous Retinal Free Flap Transplantation for Recurrent Giant Macular Hole Retinal Detachment in High Myopia

Affiliations
  • 1Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Purpose
To describe the surgical technique and clinical outcome of autologous retinal free flap transplantation for recurrent giant macular hole retinal detachment (MH RD) in a high myopia patient. Case summary: A 71-year-old female had undergone pars plana vitrectomy (PPV), internal limiting membrane peeling, and endolaser photocoagulation at the margin of the hole with silicone oil tamponade for repair of myopic MH RD. Silicone oil was removed at postoperative 4 months and the retina was properly attached. Unfortunately, the retina redetached with a large MH, which developed 8 years after surgery. The patient underwent 3-port PPV under general anesthesia. A retinal flap was harvested from the mid-periphery of the superior detached retina. The retina was cut along the marked edge of the retinal flap except for a small attachment part (hinge). After fluid-air exchange, the hinge of the retinal free flap was gently dissected and then placed on the macular area with a drop of viscoelastics. Endolaser treatment was performed around the retinal flap harvest site and silicone oil was injected at the end of surgery. The 1 week postoperative optical coherence tomography showed MH closure, which was stable at postoperative 9 months.
Conclusions
Autologous retinal free flap transplantation is an effective method as a surgical option for recurrent giant MH RD in high myopia patients.

Keyword

Autologous retinal free flap transplantation; Macular hole; Myopia; Retinal detachment
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