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SUBRETINAL TRANSPLANTATION OF AN AUTOLOGOUS RETINAL FREE FLAP FOR CHRONIC RETINAL DETACHMENT WITH PROLIFERATIVE VITREORETINOPATHY WITH AND WITHOUT MACULAR HOLE

Thomas, Akshay, S., MD, MS*; Mahmoud, Tamer, H., MD, PhD

doi: 10.1097/IAE.0000000000002026
Original Study: PDF Only

Purpose: To describe the surgical technique for subretinal transplantation of an autologous retinal free flap in cases of chronic retinal detachment with proliferative vitreoretinopathy with and without a macular hole.

Methods: Descriptive case series.

Results: Two patients with recurrent retinal detachment with proliferative vitreoretinopathy were referred for surgical evaluation. The first patient had high myopia and a macular hole. Acuity at the last time of sustained retinal reattachment was 20/400 for the first patient and counting fingers for the second patient and, in both cases, declined to light perception in the months after redetachment. Despite membrane/internal limiting membrane peeling, surgical repair required an inferior retinectomy in both cases. A retinal free flap was placed subfoveally. In the first patient, the flap was placed with the photoreceptors facing bare retinal pigment epithelium. In the second patient, the flap was inverted so its photoreceptors faced residual macular photoreceptors. The retina was flattened over the flap. Postoperatively, vision improved to 20/160 and 20/400 in the first and second patient respectively.

Conclusion: Subretinal placement of a retinal flap is possible in eyes with retinal detachment and proliferative vitreoretinopathy with and without macular hole. Whether such a flap results in superior visual and anatomical outcomes remains to be seen.

In this article, we describe the surgical technique for placement of a subretinal autologous retinal free flap for cases of chronic retinal detachment with proliferative vitreoretinopathy with and without macular hole.

*Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina; and

Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan.

Reprint requests: Tamer H. Mahmoud, MD, PhD, Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Beaumont Neuroscience Center Building, 3555 W., Thirteen Mile Road, Suite LL-20, Royal Oak, MI 48073; e-mail: thmahmoud@yahoo.com

Supported by Unrestricted Institutional Grant from Research to Prevent Blindness, New York, New York.

None of the authors has any financial/conflicting interests to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.retinajournal.com).

© 2018 by Ophthalmic Communications Society, Inc.