Autologous Retinal Transplant Repeat Surgery after Initial Graft Failure: A Case Report

Abstract Autologous retinal transplant (ART) has become an increasingly explored surgical option for managing large chronic holes refractory to standard surgical treatments. However, management strategies for patients who already failed a previous ART are less well-understood. Here, we report on a c...

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Bibliographic Details
Published inCase reports in ophthalmology Vol. 14; no. 1; pp. 576 - 582
Main Authors Chiang, TsunKang, Chu, Jeffrey, Mehra, Ankur, Sobol, Warren
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.01.2023
Karger Publishers
Subjects
autologous retinal transplant
Case Report
Case reports
Edema
graft dislocation
Optics
Patients
refractory macular hole
Retina
Retinal detachment
Surgery
Tomography
Transplants & implants
Vascular endothelial growth factor
Visual acuity
Graft dislocation
Autologous retinal transplant
Refractory macular hole
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Summary:Abstract Autologous retinal transplant (ART) has become an increasingly explored surgical option for managing large chronic holes refractory to standard surgical treatments. However, management strategies for patients who already failed a previous ART are less well-understood. Here, we report on a case of a successful repeat retinal transplant for a refractory macular hole after a previously dislocated ART graft. Subretinal injection of balanced salt solution was used to partially elevate the macular hole and secure the edge of the harvested retinal graft under the edge of the macular hole in the second operation. Postoperatively, the patient developed intraretinal fluid within the retinal graft with an appearance similar to cystoid macular edema, which was controlled with topical steroids. In addition, two separate choroidal neovascular membranes along the subretinal injection sites were seen and treated with vascular endothelial growth factor downregulation. This case illustrates successful repeat ART surgery, but further optimization of ART surgical techniques is necessary to minimize ART’s complication rate.
ISSN:1663-2699
1663-2699
DOI:10.1159/000534142