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Background <p>No consensus has been reached on the treatment of refractory/recurrent macular holes (MHs), chronic MHs, or highly myopic MHs. Although amniotic membrane transplantation (AMT) has been extended from ocular surface surgery to MH treatment, the comparative advantages of inlay versus overlay application of human amniotic membrane (hAM), as well as the impact of different preparation and preservation methods, remain controversial.</p> Methods <p>A systematic review of recent literature on AMT for MHs was conducted, categorizing applications and summarizing critical surgical considerations.</p> Results <p>Current studies indicate: Inlay AMT is suitable for complex MHs, providing mechanical support, while overlay AMT promotes better healing. Preparation methods (e.g., freeze-dried vs. fresh amniotic membrane) may affect biological activity. Surgical approaches should be tailored based on MH type, disease duration, and individual patient factors.</p> Conclusion <p>AMT offers a novel approach to MH treatment, but standardized patient selection criteria and surgical techniques require further refinement. This review provides valuable insights for clinicians in optimizing surgical strategies.</p>

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Amniotic membrane transplantation for macular holes: decoding the optimal approach—inlay or overlay?

  • 期刊论文

  • 发表日期：

    2025年10月8日

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  • Yali Liu,
  • Li Zhou,
  • Zhouli Tan

摘要

Background

No consensus has been reached on the treatment of refractory/recurrent macular holes (MHs), chronic MHs, or highly myopic MHs. Although amniotic membrane transplantation (AMT) has been extended from ocular surface surgery to MH treatment, the comparative advantages of inlay versus overlay application of human amniotic membrane (hAM), as well as the impact of different preparation and preservation methods, remain controversial.

Methods

A systematic review of recent literature on AMT for MHs was conducted, categorizing applications and summarizing critical surgical considerations.

Results

Current studies indicate: Inlay AMT is suitable for complex MHs, providing mechanical support, while overlay AMT promotes better healing. Preparation methods (e.g., freeze-dried vs. fresh amniotic membrane) may affect biological activity. Surgical approaches should be tailored based on MH type, disease duration, and individual patient factors.

Conclusion

AMT offers a novel approach to MH treatment, but standardized patient selection criteria and surgical techniques require further refinement. This review provides valuable insights for clinicians in optimizing surgical strategies.