Clinical outcomes of microincision vitrectomy for high myopia patient with macular hole retinal detachment

• Main Authors: Xiang-Ning Wang, Jia-Wei Zhao, Xuan Cai, Qiang Wu
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2018-07-01
• Series: Guoji Yanke Zazhi
• Subjects: vitrectomy; macular hole; retinal detachment; optical coherence tomography
• Online Access: http://ies.ijo.cn/cn_publish/2018/7/201807037.pdf

AIM: To observe the clinical effects of microincision vitrectomy combined with internal limiting membrane(ILM)peeling for high myopia patient with macular hole retinal detachment(MHRD). <p>METHODS: This was a retrospective non-randomized controlled clinical study. A total of 26 eyes of 26 patients with high myopic MHRD from January 2011 to December 2016 were included. All eyes underwent 23G pars plana microincision vitrectomy combined with ILM peeling. The preoperative and postoperative best corrected visual acuity(BCVA), intraocular pressure, ocular anterior segment and fundus examination were observed, and the anatomical closure of macular hole was checked by optical coherence tomography(OCT). The relationships between final BCVA and these parameters(age, GASS stage, onset time, OCT pattern of MH closure, initial vision)were examined by regression analysis. <p>RESULTS: The postoperative MH closure rate of high myopia MHRD was 58%. OCT images of the repaired MH in high myopia were categorized into 3 patterns: U-type(3 eyes)with relative normal foveal contour; V-type(4 eyes)with steep foveal contour; W-type(8 eyes)with foveal defect od neruosensory retina, but without warped hem of retinal hole or cystic formation. Multivariate Logistic regression analysis showed that postoperative BCVA was correlated with the OCT patternts of closed MH and initial vision(<i>P</i><0.05). The postoperative visual acuity of U-type closed MH was 6.9 times higher than that of W-type. <p>CONCLUSION: Microincision vitrectomy combined with ILM peeling is a safe and effective surgical treatment for high myopia patient with macular hole retinal detachment. The postoperative visual acuity was correlated with the OCT patterns of closed MH and initial vision.