Lyophilized amniotic membrane patch (LAMPatch) as a replacement of tamponades in the treatment of primary rhegmatogenous
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ORIGINAL ARTICLE
International Journal of Retina and Vitreous Open Access
Lyophilized amniotic membrane patch (LAMPatch) as a replacement of tamponades in the treatment of primary rhegmatogenous retinal detachment Mario Saravia1, Luis Zeman2* and Alejandro Berra3
Abstract Background: The basis of retinal detachment repair is sealing the retinal breaks. In order to seal the retinal breaks, chorioretinal adhesion around these lesions has to be achieved. Laser retinopexy is not immediate thus necessitates the use of a temporal endotamponade to maintain both tissues in apposition. We propose the use of a patch of lyophilized human amniotic membrane (LAMPatch) in order to occlude the retinal tear effectively until the chorioretinal adhesion is settled, overcoming the risks and limitations of the current tamponades. Methods: 23-gauge vitrectomy was performed on eyes with primary retinal detachment with single retinal breaks of less than one-hour extension. A LAMPatch was deployed over the retinal breaks after retina was repositioned with perfluorocarbon. Neither gas nor silicon oil were injected. Results: Six eyes of six patients with total or partial retinal detachment were included. Retinas remained reattached in all cases until the end on follow-up (3, 5 months). Best-corrected visual acuity at 1-week postop was between 20/30 and 20/100. Neither elevations of intraocular pressure, cataracts nor signs of inflammation were registered during follow-up. No second surgeries were needed. Conclusion: This technique has proven to be safe and effective in this small case series. No intraocular pressure rise, inflammation or cataracts were registered until last follow-up visit. Keywords: Amniotic membrane dressings, Retina, Retinal detachment, Vitreous body, Vitreoretinal surgery, Vitrectomy Background The basis of retinal detachment (RD) repair was established by Jules Gonin 100 years ago and it is still up to date: sealing the retinal break [1]. Vitrectomy has become the prevalent surgical technique, with a reattachment success rate of approximately 85–95%, regardless of the final visual acuity or side effects [2]. *Correspondence: [email protected] 2 Department of Ophthalmology, Hospital de Clínicas, Universidad de Buenos, 2351 Córdoba Ave, Buenos Aires, Argentina Full list of author information is available at the end of the article
In order to seal the retinal breaks, chorioretinal adhesion around these lesions has to be achieved. Laser retinopexy is the preferred technique, nevertheless its effect is not immediate [3], thus necessitates the use of a temporal endotamponade to maintain both tissues in apposition. Long-acting gases and silicone oil are widely used to accomplish this purpose; nonetheless, they are not exempt from side effects, namely, visual acuity impairment during tamponade, cataracts [4] and glaucoma [5] among others. Furthermore, due to their physical properties, they are prone to fail in the context of inferior retinal
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