Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Use of Thrombocyte Concentrate as Therapeutical Alternative after Unsuccessful Macular Hole Surgery

Walter A. F.1, Roider J.2
1 Dept. of Ophthalmology, Regensburg University; 2 Dept. of Ophthalmology, Christian-Albrechts University, Kiel

Purpose: There are different surgical procedures for treatment of macular holes. Despite the different methods in macular hole surgery open macular holes after vitrectomy are seldom, but require a specific procedure.
Method: Between 1998 and 2001 seven out of 92 patients with idiopathic macular holes had been operated a second time because of persisting macular holes. In five patients surgery with ILM peeling and in two patients surgery with thrombocyte concentrate had been initially performed. As second surgery in all cases thrombocyte concentrates (2.5x109/ ml) and 16% C2F6 had been used. In six out of seven cases autologous concentrate and in one out of seven cases homologous concentrate was used. The mean follow up was 21 (0.5-70) weeks.
Results: In three out of five eyes of the ILM group and in one out of two eyes of the thrombocyte group the hole was closed after the second surgery. In three out of seven cases visual improvement was significant (three or more lines = more than doubling of the angle). In the eye, where homologous concentrate was used, the hole was closed and visual acuity improved, however a faint edema around the centre of the macula could be found.
Conclusions: After unsuccessful macular holes surgery a second surgery with

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