Human Amniotic Membrane (hAM) in Macular Hole Repair: A Scoping Review.

PURPOSE: This scoping review examines the technique and outcomes for human amniotic membrane (hAM) grafts in macular hole (MHs) repair, an emerging alternative to conventional methods involving pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling, and gas endotamponade.

METHODS

A literature search of three databases was conducted on December 5, 2025.

RESULTS

66 studies involving 603 eyes were included. Most hAMs were sourced from eye banks or private companies and cut into 1-4 mm grafts using punch biopsies. All participants underwent PPV with ILM peeling. Grafts were commonly placed stromal side down using forceps, viscous injectors or under fluid or perfluorocarbon liquid. Endotamponade agents included SF6, C3F8, and silicone oil. The overall MH closure rate was 96%. Fresh hAM achieved a 100% closure rate, while cryopreserved hAM achieved 95%. Visual improvement was reported in 81% of cases, with the highest gains observed in traumatic MHs. Myopic MHs with retinal detachments had the lowest closure rate (72%). Graft dislocation was the most common complication (3.6%), and no systemic or uveitic complications were reported.

CONCLUSION

hAM grafting demonstrates high anatomical success and visual improvement with minimal complications, suggesting utility in MH repair, particularly in complex or refractory cases.