Purpose: To analyse the surgical results of a second series of full thickness idiopathic macular hole operated with autologous serum as adjuvant therapy, and to compare them to the results of a first series without autologous serum and the results of literature.
Methods: In a series of thirty-six patients, autologous serum has been used as healing adjuvant therapy. The surgical procedure included a posterior and peripherical vitrectomy combined with posterior hyaloid separation, fluid-air exchange, autologous serum injection, and final flushing with 40% sulfur hexafluoride. The patients then maintained strict face-down position post-operatively for a minimum of ten days.
Results: Anatomic success was obtained in twenty-nine cases of thirty-six patients (80%), with an anatomic success rate of 100% for the stage 2 holes. Twenty-nine patients had a pre and postoperative measurable visual acuity. Among these twenty-nine patients, median postoperative visual acuity was 20/70, compared with 20/125 preoperatively. Final visual acuity was improved in twenty-seven patients (75%), was stable five times (14%), and declined four times (11%). Among the twenty-nine anatomic successes, twenty-four (85%) improved their visual acuity. Complications were rare, and observed in the same percentage as described in literature. No complication in relation to autologous serum was noticed.
Conclusion: Autologous serum is an inexpensive, easy to obtain, healing adjuvant therapy. It seems improving the surgical results like the other adjuvants described in the litterature.