Autologous Tenon's Capsule Graft for Recurrent Retinal Detachment Associated with a Cavitary Optic Disc Anomaly following Failed Amniotic Membrane Grafting.

PURPOSE: To report the successful use of an autologous Tenon's capsule graft for recurrent retinal detachment associated with a cavitary optic disc anomaly following failed amniotic membrane grafting. METHODS: A 23-year-old woman presented with macula-off retinal detachment in the left eye caused by a large peripapillary break associated with a congenital optic disc anomaly. Initial pars plana vitrectomy with cryopreserved amniotic membrane grafting and silicone oil tamponade resulted in temporary reattachment. However, progressive shrinkage of two sequential amniotic membrane grafts led to recurrent retinal detachment complicated by proliferative vitreoretinopathy. Definitive repair was achieved through repeat vitrectomy, scleral buckling, removal of the residual amniotic membrane, and placement of a free autologous Tenon's capsule graft under perfluorocarbon liquid, followed by fluid-air exchange and 20% sulfur hexafluoride gas endotamponade. RESULTS: The postoperative course was uncomplicated. The retina remained fully attached throughout the 6-month follow-up period, with the Tenon's capsule graft maintaining a stable position over the defect. Best-corrected visual acuity improved to 20/50 at the final visit. CONCLUSION: Autologous Tenon's capsule grafting may be a useful adjunct in selected cases of recurrent retinal detachment associated with cavitary optic disc anomalies after failed amniotic membrane grafting.