Anatomical, functional outcomes, and complications of human amniotic membrane graft for macular hole: A systematic review

Abstract Standard surgical management of macular hole (MH) has its own limitations due to the broad spectrum and subtypes of the pathology itself. Human amniotic membrane (hAM) grafts have been proposed as one of the promising alternatives to the standard protocol. We conducted a systematic review to assess the anatomical, functional outcomes, and complication of the utilization of hAM grafts in the treatment of variety of MH. We searched for studies published in Pubmed, ScienceDirect, Proquest, and Cochrane databases. We included studies which reporting the use of hAM for the treatment of MH with the outcomes are MH closure, visual acuity improvement, and complications/adverse events. A total of 18 studies on 221 eyes were included in this study. In all studies, the MH closure rate was 100% in primary MH, 91% in persistent/refractory MH, 92% in high myopia (HM), 95% in retinal detachment (RD), and 100% in large MH subgroup. The VA improvement rate was 86% in primary MH subgroup, and 66% in persistent/refractory MH subgroup, 77% in HM-MH subgroup, 93% in MH-RD subgroup, and 64% in large MH subgroup. Only seven cases of complications reported in this systematic review. Transplantation of hAM plug as treatment for various MH cases results in favorable anatomical and functional outcomes. Additionally, using hAM demonstrates a low incidence of postoperative complications.