AUTOLOGOUS PLATELET CONCENTRATE AS AN ADJUNCT IN MACULAR HOLE HEALING- A PILOT-STUDY

Purpose: A pilot study was undertaken to assess the efficacy of autolo gous platelets in macular hole healing. Patients and Methods: Eight ey es of eight patients with stage 3 or 4 macular holes, two of which had failed to heal after previous vitrectomy and gas tamponade, were incl uded. The procedure consisted of pars plana vitrectomy with removal of posterior cortical vitreous, stripping of associated epimacular membr anes, 15% perfluoroethane-air tamponade, and instillation of autologou s platelet concentrate onto the posterior pole. Strict postoperative f acedown positioning was observed for 12 days. Postoperative evaluation included visual acuity measurement, biomicroscopic macular appearance and scanning laser ophthalmoscope examination. The follow-up period r anged from 3 to 13 months (mean, 7 months). Results: Of eight eyes, fl attening of the surrounding retina and closure of the hole were achiev ed in seven (87.5%). Visual acuity improved two lines or more in four eyes (50%). Four eyes (50%) reached a postoperative visual acuity of 2 0/50 or more. Increased nuclear sclerosis was observed in six eyes (75 %), and retinal detachment occurred in two eyes (25%). Conclusions: Au tologous platelet concentrate administered peroperatively in full-thic kness macular holes seems to be a safe and effective adjunct to vitrec tomy with removal of posterior hyaloid and gas tamponade. A larger mul ticenter randomized prospective study is underway to verify these enco uraging results before advocating the use of autologous platelets in m acular hole surgery.