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Conventional macular hole repair often involves vitrectomy and gas tamponade. However, human amniotic membrane grafts are emerging as a powerful alternative for complex cases. Recent data highlights their impressive success rates in restoring retinal anatomy and improving patient outcomes.
A comprehensive scoping review of 603 eyes reported a 96% anatomical closure rate. Notably, fresh grafts achieved a perfect closure rate of 100%. Cryopreserved options also performed exceptionally well, maintaining a 95% success rate. Furthermore, 81% of patients experienced significant visual improvement after the procedure. Therefore, this technique serves as a viable salvage option when standard internal limiting membrane peeling fails to close the hole. Consequently, surgeons find it particularly useful for traumatic or refractory cases.
Surgeons typically place the grafts stromal side down during the procedure to promote biological healing. Additionally, surgeons often cut these grafts using precise punch biopsies before placement over the macular defect. Using perfluorocarbon liquid helps in maintaining precise graft positioning during the surgery. Most patients undergo gas endotamponade with agents like SF6 or C3F8 to ensure stability. Nevertheless, graft dislocation occurred in approximately 3.6% of cases, requiring close postoperative monitoring. The risk of systemic or uveitic complications remains extremely low, making it a safe choice for most patients.
The overall anatomical closure rate is approximately 96%, with fresh grafts reaching 100% success in the reported clinical studies.
Myopic macular holes associated with retinal detachments show slightly lower closure rates, averaging around 72% in complex cohorts.
Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a professional relationship. Always seek the advice of a qualified healthcare provider for any medical condition or treatment. Refer to the latest local and national guidelines for clinical practice.
References
Solish D et al. Human Amniotic Membrane (hAM) in Macular Hole Repair: A Scoping Review. Retina. 2026 May 06. doi: 10.1097/IAE.0000000000004877. PMID: 42090195.
Doguizi S et al. Surgical Outcomes of Epiretinal Human Amniotic Membrane Transplantation for Refractory Macular Holes. MDPI. 2026.
Rizzo S et al. Human amniotic membrane (hAM) in vitreoretinal surgery. Retina. 2019;39(Suppl 1):S95-S103.
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