Autologous Platelet Concentrate as an Adjunct in Macular Hole HeaJing A Pilot Study Korobelnik, MD, l Daniele Hannouche, MD,l Nacera Belayachi, MD,1 Michel Branger, MD,2 Jean-Eric Guez, MD,3 Thanh Hoang-Xuan, MDI Purpose: A pilot study was undertaken to assess the efficacy of autologous platelets in macular hole healing. Patients and Methods: Eight eyes of eight patients with stage 3 or 4 macular holes, two of which had failed to heal after previous vitrectomy and gas tamponade, were included. The procedure consisted of pars plana vitrectomy with removal of pos- terior cortical vitreous, stripping of associated epimacular membranes, 15% perfluo- roethane-air tamponade, and instillation of autologous platelet concentrate onto the posterior pole. Strict postoperative facedown positioning was observed for 12 days. Postoperative evaluation included visual acuity measurement, biomicroscopic macular appearance and scanning laser ophthalmoscope examination. The follow-up period ranged from 3 to 13 months (mean, 7 months). Results: Of eight eyes, flattening of the surrounding retina and closure of the hole were achieved in seven (87.5%). Visual acuity improved two lines or more in four eyes (50%). Four eyes (50%) reached a postoperative visual acuity of 20/50 or more. Increased nuclear sclerosis was observed in six eyes (75%), and retinal detachment occurred in two eyes (25%). Conclusions: Autologous platelet concentrate administered peroperatively in full- thickness macular holes seems to be a safe and effective adjunct to vitrectomy with removal of posterior hyaloid and gas tamponade. A larger multicenter randomized pro- spective study is underway to verify these encouraging results before advocating the use of autologous platelets in macular hole surgery. Ophthalmology 1996;103:590-594 Originally received: August 15 , 1995. Revision accepted: December 21, 1995. Idiopathic macular holes are responsible for visual im- pairment in elderly patients. They are attributed to tan- gential vitreomacular tractions according to Gass. 1 They are no longer uniformly associated with irreversible visual loss, because resolution of the surrounding subretinal fluid and re-application of the hole edges have been achieved after relieving tangential vitreous tractions by vitrectomy, removing the posterior vitreous cortex and gas tampon- ade. 2 -4 The rate of anatomic success has been improved by preoperative administration of wound healing ad- juncts. 5 - S Platelets contain growth factors such as epider- mal growth factor, ftbronectin, and transforming growth I Department of Ophthalmology, Bichat-Claude Bernard hospital, Paris, France. 2 Department of Hemobiology, Bichat-Oaude Bernard hospital, Paris, France. 3 Department of Biophysics, Lariboisiere hospital, Paris, France. The authors have no proprietary interest in any of the materials used in this study. Reprint requests to lean-Fran90is Korobelnik, MD, Department of Ophthalmology, Bichat-Oaude Bernard hospital, 46 rue Henri Huchard, 75877 Paris Cedex 18, France. 590