Journal Article (Journal Article)

PURPOSE: To evaluate the feasibility and initial functional and anatomical outcomes of transplanting a full-thickness free graft of choroid and retinal pigment epithelium (RPE), along with neurosensory retina in advanced fibrosis and atrophy associated with end-stage exudative age-related macular degeneration with and without a concurrent refractory macular hole. METHODS: During vitrectomy, an RPE-choroidal and neurosensory retinal free graft was harvested in nine eyes of nine patients. The RPE-choroidal and neurosensory retinal free graft was either placed subretinally (n = 5), intraretinally to cover the foveal area inside an iatrogenically induced macular hole over the RPE-choroidal graft (n = 3) or preretinally (n = 1) without a retinotomy wherein both free grafts were placed over the concurrent macular hole. Silicone oil endotamponade was used in all cases. RESULTS: Mean follow-up was 7 ± 5.5 months (range 3-19). The mean preoperative visual acuity was ∼count fingers (logarithm of the minimum angle of resolution = 2.11, range 2-3), which improved to ∼20/800 (logarithm of the minimum angle of resolution 1.62 ± 0.48, range 0.7-2, P = 0.04). Vision was stable in 5 eyes (55.6%) and improved in 4 eyes (44.4%). Reading ability improved in 5 eyes (55.6%). Postoperative complications were graft atrophy (n = 1), epiretinal membrane (n = 1), and dislocation of neurosensory retina-choroid-RPE free graft (n = 1). CONCLUSION: Combined autologous RPE-choroid and neurosensory retinal free graft is a potential surgical alternative in eyes with end-stage exudative age-related macular degeneration, including concurrent refractory macular hole.

Full Text

Duke Authors

Cited Authors

  • Parolini, B; Grewal, DS; Pinackatt, SJ; Baldi, A; Di Salvatore, A; Besozzi, G; Finzi, A; Cardillo, D; Mahmoud, TH

Published Date

  • September 2018

Published In

Volume / Issue

  • 38 Suppl 1 / Suppl 1

Start / End Page

  • S12 - S22

PubMed ID

  • 29210941

Pubmed Central ID

  • PMC5966319

Electronic International Standard Serial Number (EISSN)

  • 1539-2864

Digital Object Identifier (DOI)

  • 10.1097/IAE.0000000000001914


  • eng

Conference Location

  • United States