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Surgical management of retinal detachment associated with myopic macular hole: anatomic and functional status of the macula.

Abstract：

PURPOSE:To evaluate the postoperative status of the macula after vitreous surgery with internal limiting membrane removal for macular hole related retinal detachment in patients with severe myopia. DESIGN:Interventional case series. METHODS:We prospectively examined 10 eyes with retinal detachment associated with a myopic macular hole from 10 consecutive patients, and performed pars plana vitrectomy with internal limiting membrane peeling. Macular buckling was performed in one eye during the initial treatment and in three eyes during subsequent operations. The main outcome measures were the anatomic reattachment rate and the postoperative status of the macular hole. We examined the macular area pre- and postoperatively with slit-lamp biomicroscopy and with a scanning laser ophthalmoscope. Cross-sectional imaging of the macular area was conducted with optical coherence tomography. RESULTS:Successful retinal reattachment was achieved in seven eyes (70%) after the initial surgery and in three eyes (30%) after additional procedures. Visual acuity remained unchanged in two eyes (20%), and improved by two or more logarithmic units of minimum angle of resolution (logMAR) measurement in eight eyes (80%). The macular hole was anatomically closed in only one eye (10%). Postoperative enlargement of the macular hole was observed in seven eyes. CONCLUSIONS:In highly myopic eyes with macular hole related retinal detachment, closure of the macular hole is difficult to attain despite the complete relief of tangential traction by internal limiting membrane peeling. Results indicate the presence of a possible imbalance between the retina and the choroid-sclera complex associated with axial elongation and posterior staphyloma in highly myopic eyes.

journal_name

Am J Ophthalmol

journal_title

American journal of ophthalmology

authors

Ichibe M,Yoshizawa T,Murakami K,Ohta M,Oya Y,Yamamoto S,Funaki S,Funaki H,Ozawa Y,Baba E,Abe H

doi

10.1016/s0002-9394(03)00186-7

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

277-84

issue

eissn

0002-9394

issn

1879-1891

pii

S0002939403001867

journal_volume

136

pub_type

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Surgical management of retinal detachment associated with myopic macular hole: anatomic and functional status of the macula.