title: Autologous transplantation of the internal limiting membrane for refractory macular holes.
abstract: OBJECTIVE
  To determine the effectiveness of autologous transplantation of the internal limiting membrane (ILM) for refractory macular holes.
  
  
  METHODS
  Prospective, interventional case series.
  
  
  METHODS
  Ten eyes of 10 consecutive patients who underwent autologous transplantation of the ILM for the treatment of refractory macular holes were studied. The primary diseases in these patients were large idiopathic macular holes that had existed for more than 1 year (4 eyes), a traumatic macular hole (1 eye), myopic foveoschisis (2 eyes), foveoschisis resulting from pit-macular syndrome (2 eyes), and proliferative diabetic retinopathy (1 eye). Apart from the 5 eyes with idiopathic or traumatic macular holes, macular holes developed in the other 5 eyes after initial vitrectomies with ILM removal. In all eyes, regular macular hole surgery failed to achieve closure. The main outcome measures used in this study were macular hole closure and best-corrected visual acuity (BCVA).
  
  
  RESULTS
  Macular holes were closed successfully in 9 eyes (90%) after autologous transplantation of the ILM. The postoperative BCVAs were significantly better than the preoperative BCVAs (P = .007, paired t test). Postoperative BCVAs improved by more than 0.2 logarithm of the minimal angle of resolution units in 8 eyes (80%) and were unchanged in 2 eyes (20%).
  
  
  CONCLUSIONS
  Although this is a pilot study, the results suggest that autologous transplantation of the ILM may contribute to improved anatomic and visual outcomes in the treatment of refractory macular holes and may warrant further investigation.
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Electronic address: moriza-y@okayama-u.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Morizane
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Kimura
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Hosokawa
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shiode
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Kawata
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Hosogi
authors.affiliation: Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Shirakata
authors.affiliation: Department of Ophthalmology, Kurashiki Medical Center, Okayama, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Okanouchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000637:transplantation*; D058450:Endotamponade; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D010865:Pilot Projects; D016684:Prone Position; D011446:Prospective Studies; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D013459:Sulfur Hexafluoride