• Shaanxi Ophthalmic Medical Center, Xi′an No.4 Hospital, Affiliated Guangren Hospital, School of Medicine, Xi′an Jiaotong University, Xi′an 710004, China;
Myopia, degenerative/surgery; Retinal detachment/surgery; Retinal perforations/surgery; Vitrectomy
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Objective  To compare the outcome of pars plana vitrectomy (PPV) with triamcinolone (TA) assistance and internal limiting membrane (ILM) peeling for the treatment of moderate and extreme highly myopic macular hole retinal detachment (MHRD). Methods  Forty-one highly myopic MHRD patients (41 eyes) who underwent PPV with TA assistance and ILM peeling were enrolled in this study. These eyes were divided into two groups according to different anatomic features: group A (24 eyes) had a consistent moderate long axial lengths (＜29 mm),  quot;mild quot; retinal pigment epithelium (RPE) and chorioretinal atrophy, and posterior staphyloma (level 0 - 1 and depth  le;2 mm); while group B (17 eyes) had a consistent extreme long axial lengths ( ge;29 mm),  quot;severe quot; RPE and chorioretinal atrophy, and posterior staphyloma (level 2 - 3 and depth＞2 mm). All the patients underwent C3F8 tamponade at the end of PPV. The anatomic reattachment of the retina, macular hole closure, and visual acuity were observed at 12 months after surgery. Results  The rates of retinal reattachment and macular hole closure were 91.67% and 58.33% in group A, 64.71% and 17.65 % in group B in the first time of surgery. The differences of rates of retinal reattachment (P=0.049) and macular hole closure ( chi;2=6.787, P=0.009) between two groups were statistically significant. The rates of retinal reattachment and macular hole closure were 95.83% and 58.33% in group A, 88.23% and 29.53% in group B in the second time of surgery. The difference of retinal reattachment rate between two groups was not statistically significant (P=0.560). The difference of macular hole closure rate between two groups was statistically significant ( chi;2=4.894, P=0.027). Twelve months after surgery, the vision acuity improved in 14 eyes, unchanged in nine eyes, and decreased in one eye in group A; the vision acuity improved in six eyes, unchanged in eight eyes, and decreased in three eyes in group B. The differences of vision result between two groups was not statistically significant ( chi;2=0.209, P=0.647). Conclusion  After PPV with TA assistance and ILM peeling, the rates of retinal reattachment and macular hole closure in eyes with moderate highly myopic MHRD are higher than that in eyes with extreme highly myopic MHRD, but there is no difference in visual acuity.

Citation： WEI Yong,WANG Runsheng,ZHU Zhongqiao,et al.. Efficacy of vitrectomy for moderate and extreme highly myopic macular hole retinal detachment. Chinese Journal of Ocular Fundus Diseases, 2013, 29(2): 142-145. doi: Copy