title: Blood clump-assisted vitrectomy and internal limiting membrane peeling for macular hole repair.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of using diluted autologous blood clumps to assist in vitrectomy and internal limiting membrane (ILM) peeling for macular hole (MH) repair.
  
  
  METHODS
  Twenty-six patients with MHs who underwent ILM peeling were enrolled. The blood clump solution was prepared by mixing autologous whole blood with 5% glucose water. This solution was introduced to identify the posterior vitreous and was then used to coat the surface of the ILM in the macular area. The blood clump-coated ILM was removed with forceps in a circular fashion. The MH closure rate, the pre- and postoperative best-corrected visual acuity change, and retinal changes were evaluated.
  
  
  RESULTS
  The blood clump-assisted procedure effectively labeled the posterior vitreous and coated the ILM, enhancing the visibility of ILM and, thus, facilitating MH repair. The MHs were closed by a single surgery in 24 eyes (92%), and the other 2 holes were closed after a second gas-fluid exchange. The pre- and postoperative mean best-corrected visual acuities were 0.96 ± 0.3 and 0.38 ± 0.3 (logarithm of the minimum angle of resolution visual acuity ± SD, P < 0.001), respectively. No toxic fundus changes were observed during the follow-up period.
  
  
  CONCLUSIONS
  This novel blood clump-assisted procedure effectively labeled the posterior vitreous and coated the ILM, enhancing the visibility of ILM and thereby facilitating MH repair.
authors.affiliation: Department of Ophthalmology, Chang-Gung Memorial Hospital, Taoyuan, Taiwan. CCL404@cgmh.org.tw
authors.forename: Chi-Chun
authors.initials: CC
authors.lastname: Lai
authors.forename: Nan-Kai
authors.initials: NK
authors.lastname: Wang
authors.forename: Lan-Hsin
authors.initials: LH
authors.lastname: Chuang
authors.forename: Wei-Chi
authors.initials: WC
authors.lastname: Wu
authors.forename: Ling
authors.initials: L
authors.lastname: Yeung
authors.forename: Yih-Shiou
authors.initials: YS
authors.lastname: Hwang
authors.forename: Kuan-Jen
authors.initials: KJ
authors.lastname: Chen
authors.forename: Tun-Lu
authors.initials: TL
authors.lastname: Chen
mesh_terms: D001485:Basement Membrane / Q000601:surgery*; D001769:Blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*