Patching Peripheral Retinal Breaks on Atrophic Choroid: A Prospective Pilot Study to Prevent Redetachment

Abstract

Purpose: To evaluate the efficacy and safety of bovine pericardium (Tutopatch) to seal peripheral retinal breaks located over areas of chorioretinal atrophy in highly myopic eyes. Methods: Highly myopic patients with retinal detachment (RD) caused by retinal breaks over areas of chorioretinal atrophy underwent 25-gauge pars plana vitrectomy, subretinal fluid drainage, and silicone oil (SO) tamponade. A trimmed Tutopatch was placed over the retinal breaks. Follow-up assessments were performed over 12 months, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), fundus photography, and widefield optical coherence tomography. Results: Seven eyes of highly myopic patients were included in this study. All eyes achieved complete retinal reattachment, with no recurrence of detachment after SO removal. The median BCVA improved from 0.10 (20/200 Snellen) preoperatively to 0.20 (20/100 Snellen) postoperatively. In addition, the mean IOP increased preoperatively from 13.0 ± 2.6 mm Hg to 15.0 ± 4.2 mm Hg postoperatively. The Tutopatch remained adherent to the retina throughout follow-up, without signs of inflammation, epiretinal membrane formation, or other complications. Conclusions: Tutopatch appears to be a safe and effective method for sealing retinal breaks in areas of chorioretinal atrophy in which conventional treatments are not available. This technique may help prevent redetachment in highly myopic eyes. Larger studies are warranted to confirm our findings.