Received: 16 December 2019; Published on-line: 11 February 2020

Surgical technique for persistent macular holes with application of the leucocyte and platelet rich plasma obtained with the Ycellbio system

D.V. Zhmuryk, Cand Sc (Med); M.V. Miliienko; O.G. Volochanska

Kyiv Municipal Clinical Eye Hospital “Eye Microsurgery Center”;   Kyiv (Ukraine)

E-mail:  miliienko.m@gmail.com

TO CITE THIS ARTICLE: Zhmuryk DV, Miliienko MV, Volochanska OG. Surgical technique for persistent macular holes with application of the leucocyte and platelet rich plasma obtained with the Ycellbio system. J.ophthalmol.(Ukraine).2020;1:28-31. http://doi.org/10.31288/oftalmolzh202012831


Background: Treatment of persistent macular holes (MH) remains a challenge in spite of recent advances in macular surgery. In re-surgery in case of persistent MH, there is lack of internal limiting membrane (ILM) tissue for adequate MH closure. Application of leucocyte and platelet rich plasma (PRP) to the macular hole is one of the various techniques that may be used to improve the success rate of surgery for persistent MHs. The use of the funnel-shaped Ycellbio system with a red blood cell (RBC) control lever provides easy and effective PRP extraction process.

Purpose: To assess the efficacy of surgical treatment for persistent MHs with application of the PRP obtained with YCELLBIO PRP preparation kit to the MH area.

Material and Methods: Ten patients with eyes diagnosed with persistent MH were under observation at the Kyiv Municipal Clinical Eye Hospital “Eye Microsurgery Center” from September 2018 to February 2019. Before re-surgery, mean macular hole size was 894 ± 115 μm, and best-corrected visual acuity varied from 0.03 to 0.1. PRP was obtained using a fixed-angle rotor centrifuge at 3600 rpm with an YCELLBIO PRP preparation kit. Each patient received a closed subtotal vitrectomy with application of the PRP to MH area and subsequent vitreous endotamponade with 20% С3F8.

Results: The surgical procedure for persistent MH promoted anatomical closure in 9/10 eyes (9/10 patients). In addition, postoperative BCVA was 0.1 or better in 8/10 patients, and worse than 0.1 in 2/10 patients.

Conclusion: Application of the PRP obtained with the Ycellbio system is an effective method of treatment and may be considered as a method of choice for surgical treatment of persistent macular holes.

Keywords: macular hole, leucocyte and platelet rich plasma маса,  Ycellibiо



1.Machemer R, Buettner H, Norton EW, Parel JM. Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol. 1971; 75(4): 813-20.

2.Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991; 109(5):654-9.

3.Michalewska Z, Michalewski J, Adelman RA, et al . Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology. 2010; 117(10):2018-25.

4.Cheung CMG, Munshi V, Mughal S, et al. Anatomical success rate of macular hole surgery with autologous platelet without internal-limiting membrane peeling. Eye. 2005; 19(11):1191-3.

5.Chen A-N, Yang C-M. Lens capsular flap transplantation in the management of refractory macular hole from multiple etiologies. Retina. 2016; 36(1):163-70.

6.D.V. Zhmuryk, M.V. Miliienko. [Optimizing tactics for management of patients with persistent large macular holes]. Oftalmologiia. Vostochnaia Evropa. 2017;7(2):181-6. Russian.

7.Dimopoulos S, William A, Voykov B, et al. Anatomical and visual outcomes of autologous thrombocyte serum concentrate in the treatment of persistent full-thickness idiopathic macular hole after ILM peeling with brilliant blue G and membrane blue dual. Acta Ophthalmol. 2017; 95(5):429-30.

8.Gaudric A, Massin P, Paques M, et al. Autologous platelet concentrate for the treatment of full-thickness macular holes. Graefes Arch Clin Exp Ophthalmol. 1995; 233(9). 549-54.

9.Shkvorchenko DO, Zakharov VD, Krupina EA, et al. [Surgical treatment of macular holes with application of platelet-rich plasma]. Oftalmokhirurgiia. 2017;(3):27-30. Russian.


The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.