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TREATMENT OF RETINAL DETACHMENT SECONDARY TO MACULAR HOLE IN HIGHLY MYOPIC EYES: Pars Plana Vitrectomy with Internal Limiting Membrane Peel and Silicone Oil Tamponade

Meng, Li MD*,†; Wei, Wenbin MD*; Li, Yanlong MD; Han, Xiaodong MD; Shi, Xiaobo MD; Yang, Min MD

doi: 10.1097/IAE.0b013e31829d004b
Original Study

Purpose: To evaluate efficacy of vitrectomy with internal limiting membrane peel and silicone oil tamponade in highly myopic eyes with retinal detachment secondary to macular hole (MH).

Methods: Twenty-one consecutive cases of MH–retinal detachment in highly myopic eyes were retrospectively reviewed. Eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and silicone oil tamponade. A face-down or side-lying position was maintained postoperatively. Silicone oil was removed 3 months to 12 months later. Outcomes included MH closure and retinal reattachment rates, best-corrected visual acuity, and complication rates.

Results: Mean patient age was 59.3 ± 6.5 years and mean spherical equivalent was −15.2 ± 4.3 diopters. After silicone oil removal, 18 eyes (86%) had MH closure with retinal reattachment and 2 eyes needed reattachment with endolaser photocoagulation and fluid/gas exchange, and 1 patient refused further treatment. At the last follow-up, median best-corrected visual acuity was +1.48 ± 0.12, up from preoperative +2.11 ± 0.17 (P = 0.03). Transient intraocular pressure elevation was observed in 11 eyes (52%). Iatrogenic retinal break occurred in one case.

Conclusion: Combining pars plana vitrectomy with internal limiting membrane peel and silicone oil tamponade was safe and effective in treating MH–retinal detachment in highly myopic eyes. Silicone oil tamponade may improve initial anatomical success rates because of longer tamponade duration.

The reattachment rate for retinal detachment secondary to macular hole in highly myopic eyes was examined. Pars plana vitrectomy, in combination with silicone oil tamponade, was used in all cases. Reattachment rate was higher than that reported for gas bubble tamponade.

*Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China; and

Xi’an Aier Ancient City Eye Hospital, Xi’an, Shaanxi, China.

Reprint requests: Wenbin Wei, MD, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China; e-mail: trweiwenbin@yahoo.com.cn

None of the authors have any financial/conflicting interests to disclose.

This study was performed at Xi’an Aier Ancient City Eye Hospital without any funding.

© 2014 by Ophthalmic Communications Society, Inc.