Years of experience in the use of autologous conditioned blood plasma for macular holes

Topicality. Macular hole is an acquired disease characterized by a through defect of retinal tissue in the macular zone, leading to decreased central vision, the occurrence of metamorphopsia and central scotoma. In recent years, in the treatment of this condition, techniques associated with closing the macular defect with autologous blood and its components have become increasingly interesting. In particular, the use of autologous conditioned plasma obtained by centrifugation in a patented double syringe. Purpose. Analysis of our own clinical results over five years of experience in using ACP in the treatment of macular holes of various diameters. Materials and methods. 102 patients (102 eyes), whose age ranged from 50 to 65 years, were under observation. Depending on the size of the hole, the patients were divided into three groups. The surgical tactics for treating macular holes consisted of vitrectomy using the standard 3-port 25 G. Autologous conditioned plasma (ACP) was obtained by collecting 20 ml of the patient's venous blood, followed by centrifugation for 5 minutes using a proprietary dual syringe (Arthrex ACP) and applying the contents to the area of the rupture. Patients were followed up for 6 months after surgery. Results. Complete closure of the macular hole with the formation of the foveal fossa was achieved in 94.2 % of cases. In 6 patients there was no complete approximation of the edges of the macular hole. These patients were taken for revision surgery using mechanical approximation of the edges of the macular hole. OCT follow-up after 6 months revealed no recurrence of macular tears in all patients. Conclusion. The possibility of local use of ACP plasma in vitreomacular interface surgery, in particular for macular holes, taking into account its regenerative and reparative properties, allows one to obtain a good anatomical and functional result with the achievement of high visual functions and minimize trauma to the retinal tissue during surgery.

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