A Sandwich-Type Double-Layer Amniotic Membrane Graft for Repairing Myopic Macular Hole-Related Retinal Detachment in a Child with Knobloch Syndrome

This case report describes a surgical technique using double-layer human amniotic membrane (hAM) grafting to repair a high myopic macular hole (MH)-related chronic retinal detachment (RD) with subretinal bands in a child with Knobloch syndrome. A 4-year-old boy diagnosed with Knobloch syndrome prese...

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Bibliographic Details
Published in:Turk oftalmoloji gazetesi Vol. 55; no. 1; pp. 57 - 60
Main Authors: Abdullah, Omer Othman, Özdemir Zeydanlı, Ece, Özdek, Şengül
Format: Journal Article
Language:English
Published: Turkey Galenos Yayinevi Tic. Ltd 27.02.2025
Turkish Ophthalmology Society
Subjects:
Amnion - transplantation
Child, Preschool
Corneal Dystrophies, Hereditary - complications
Encephalocele
Endotamponade
human amniotic membrane
Humans
knobloch syndrome
macular hole-related retinal detachment
Male
Myopia - complications
Myopia, Degenerative - complications
pediatric high myopia
pediatric retinal detachment
Retinal Degeneration
Retinal detachment
Retinal Detachment - congenital
Retinal Detachment - diagnosis
Retinal Detachment - etiology
Retinal Detachment - surgery
Retinal Perforations - complications
Retinal Perforations - diagnosis
Retinal Perforations - etiology
Retinal Perforations - surgery
Tomography, Optical Coherence
Vision disorders in children
Visual Acuity
Vitrectomy - methods
human amniotic membrane
Knobloch syndrome
pediatric high myopia
Pediatric retinal detachment
macular hole-related retinal detachment
ISSN:1300-0659, 2149-8709, 2147-2661, 2149-8709
Online Access:Get full text
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Summary:This case report describes a surgical technique using double-layer human amniotic membrane (hAM) grafting to repair a high myopic macular hole (MH)-related chronic retinal detachment (RD) with subretinal bands in a child with Knobloch syndrome. A 4-year-old boy diagnosed with Knobloch syndrome presented with macular atrophy in the right eye and chronic total RD with subretinal bands associated with a myopic MH in the left eye. The surgery involved an encircling band, pars plana vitrectomy, and subretinal band extraction through a retinotomy. The retinotomy and MH were sealed using hAM with a 5000 centistoke (cS) silicone oil (SO) tamponade. RD recurred two weeks postoperatively due to hAM contracture, leading to MH reopening. A second intervention included replacing the contracted graft with two larger hAM grafts; the first positioned under the MH and the second over the MH in a sandwich configuration, with 5000 cS SO tamponade. Eighteen months after SO removal, a flat retina, closed MH, and ambulatory vision were achieved. In conclusion, double-layer hAM grafting provides a strong seal for MH in high myopia-associated RD where conventional techniques fail.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:1300-0659
2149-8709
2147-2661
2149-8709
DOI:10.4274/tjo.galenos.2025.15675