Treatment of retinal detachment secondary to macular hole in high myopia: vitrectomy with dissection of the inner limiting membrane to the edge of the staphyloma and long-term tamponade

Abstract

Purpose: To evaluate the rates of retinal reattachment and the closure of myopic macular hole because of posterior pole retinal detachment after treatment with pars plana vitrectomy and subsequent dissection of the inner limiting membrane.

Methods: Prospective noncomparative study of 27 eyes from 27 phakic patients diagnosed with posterior pole retinal detachment as a result of myopic macular hole. All underwent pars plana vitrectomy with dissection of the inner limiting membrane and intravitreal silicone oil tamponade performed by the same surgeon. The main variables assessed were visual acuity, retinal reattachment, and macular hole closure determined by optical coherence tomography.

Results: Of the 27 eyes, 16 (59.3%) were right eyes and 11 (40.7%) were left eyes. Mean age was 50.5 years. Myopia ranged from -9 diopters (D) to -27 diopters (mean, -18 diopters), and axial length ranged from 28.5 mm to 35.6 mm (mean, 32.05 mm). After a mean postoperative period of 12 months, retinal reattachment was found in 85.1% of the patients and anatomical closure of the macular hole in 51.9%.

Conclusion: This technique offers good rates of retinal reattachment and macular hole closure, although seldom increases the final visual acuity. It showed limited effectiveness in eyes with an axial length >30 mm.