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The no-retina-touch technique: vitrectomy and platelet-rich plasma in the treatment of lamellar macular hole. New insights into pathogenesis

Eye volume 39, pages 300–306 (2025)Cite this article

Subjects

Abstract

Purpose

To explore the use of autologous platelet-rich plasma (PRP) as a potential therapeutic adjuvant strategy for treating degenerative lamellar macular holes (LMHs).

Design

A prospective interventional case series.

Methods

Seven consecutive patients (8 eyes) with a diagnosis of LMH underwent a pars-plana vitrectomy with PRP injection under air tamponade. Anatomical results based on spectral ___domain optical coherence tomography (SD-OCT) and functional results, in terms of best corrected visual acuity (BCVA) and reading performance, were analyzed.

Results

At 12 months postoperatively, 7 out of 8 eyes (88%) presented a complete closure of the LMH. The ellipsoid zone (EZ) was restored in 3 eyes (37.5%). The mean (±SD) postoperative BCVA was 0.39 (±0.56) LogMAR, resulting in a statistically significant visual acuity improvement (p = 0.007). The mean (±SD) maximum reading speed (MaxRS) improved to 133.48 (±41.47) wpm, with a significant increase compared to the baseline (p = 0.029). The mean (±SD) reading acuity score (RA score) resulted in 0.44 (±0.04) LogRAD, with an improvement in reading acuity that did not reach statistical significance (p = 0.129).

Conclusions

The utilization of the PRP technique with a no-retina-touch approach safeguards the delicate retinal tissues, minimizing the possibility of iatrogenic trauma or post-operative complications, while maintaining a high rate of efficacy in enabling the improvement of the foveal defect in lamellar macular holes.

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Fig. 1: baseline (on the left) and 12 months (on the right) postoperative OCT images of patients 1 to 4.
Fig. 2: baseline (on the left) and 12 months (on the right) postoperative OCT images of patients 5 to 8.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at the University of Turin.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Turin, Turin, Italy

    Federico Ricardi, Francesco Gelormini, Guglielmo Parisi, Veronica Vallino, Enrico Borrelli, Paola Marolo & Michele Reibaldi

  2. Blood Bank, “Città della Salute e della Scienza” Hospital, Turin, Italy

    Sergio D’Antico & Marika Salafia

Authors
  1. Federico Ricardi
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  2. Francesco Gelormini
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  3. Guglielmo Parisi
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  4. Veronica Vallino
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  5. Enrico Borrelli
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  6. Paola Marolo
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  7. Sergio D’Antico
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  8. Marika Salafia
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  9. Michele Reibaldi
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Contributions

Michele Reibaldi had the idea for the article. Federico Ricardi, Francesco Gelormini, Guglielmo Parisi, Veronica Vallino, Enrico Borrelli, Paola Marolo, and Michele Reibaldi equally contributed to the literature search, study design, and implementation, as well as participated in the writing of the paper. Sergio D’Antico and Marika Salafia have been contributing to the critical revision of the PRP preparation and the conclusions. All authors approved the final version of this manuscript.

Corresponding author

Correspondence to Francesco Gelormini.

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Ricardi, F., Gelormini, F., Parisi, G. et al. The no-retina-touch technique: vitrectomy and platelet-rich plasma in the treatment of lamellar macular hole. New insights into pathogenesis. Eye 39, 300–306 (2025). https://doi.org/10.1038/s41433-024-03414-5

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