Macular buckling combined with autologous retinal transplantation for the treatment of recurrent macular hole retinal detachment: A case report.

RATIONALE: Recurrent macular hole retinal detachment (MHRD) in high myopia is a challenging clinical problem with limited therapeutic options. Traditional treatments, such as pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling, often fail to achieve satisfactory outcomes in these complex cases. This study aims to report a novel surgical approach involving macular buckling and autologous retinal transplantation for the treatment of recurrent MHRD in high myopia, highlighting its potential to improve anatomical and functional outcomes.

PATIENT CONCERNS: A 63-year-old female patient presented with decreased vision in her left eye, 2 months after the removal of silicone oil (SO). She had previously undergone PPV, ILM peeling, and SO tamponade in the same eye. Her best corrected visual acuity (BCVA) was hand movement, and axial length was 30.81 mm. Optical coherence tomography (OCT) revealed retinal detachment involving the posterior pole with a macular hole.

DIAGNOSES: Recurrent macular hole retinal detachment in the left eye was diagnosed.

INTERVENTIONS: Given concerns about insufficient residual ILM, the patient underwent a combined surgical procedure, including PPV, autologous retinal transplant, macular buckling, and SO tamponade.

OUTCOMES: At 1 month postoperatively, her BCVA was improved to 20/250, and OCT showed a flattened retina with a closed macular hole. However, at 3 months postoperatively, complications such as elevated intraocular pressure, dust keratic precipitates, and anterior chamber inflammation occurred, resulting in a decrease in visual acuity to counting fingers at 1 m. These complications persisted for 1 month before stabilizing and resolving following the removal of silicone oil. Subsequent follow-up revealed stable retinal reattachment, macular hole closure, and improved BCVA to 20/100.

LESSONS: This combined surgical procedure resulted in improved retinal reattachment and macular hole closure, as well as the restoration of the anatomical structure and functional integrity of the retinal posterior region in the recurrent MHRD patient.