Comparison of clinical efficacy of vitrectomy for macular hole induced retinal detachment in high myopia and for rhegmatogenous retinal detachment with macular hole

Abstract

Objective To compare the outcomes of vitrectomy and internal limiting membrane peeling for the treatment of macular hole retinal detachment(MHRD) in high myopia and rhegmatogenous retinal detachment with macular hole (RRD+ MH). Methods In this retrospective case-control study, 51 eyes of 51 consecutive patients of retinal detachment with macular hole received standard pars plana vitrectomy with internal limiting membrane peeling and 16% C3F8/silicon oil tamponade. They were divided into two groups. Thirty eyes of MHRD with axial high myopia (the axial length longer than 26.0 mm) were in research group (high myopia group) and 21 eyes of 21 patients with RRD+ MH were in control group (RRD+ MH group). Anatomical closure of macular holes using optical coherence tomography (OCT) and final best-corrected visual acuity (BCVA) were compared between the two groups. Results Anatomical closure of the macular hole confirmed by OCT was achieved in 29 of 30 eyes (96.67%) in the high myopia group, and in 19 of 21 eyes (90.48%) in the RRD+ MH group. There was no statistically significant difference between the two groups (χ2=0.10, P=0.75). In the high myopia group, the mean LogMAR VA was (1.13±0.50) at the final follow-up after the surgery, and it was (1.87±0.55) before the surgery. In the RRD+ MH group, it was(2.00±0.54) before surgery and(1.16±0.51) after surgery. There was no significant statistically difference between the two groups in visual increase (p=0.66). Conclusion Vitrectomy and internal limiting membrane peeling with C3F8/silicone oil tamponade is effective for the treatment of macular hole induced retinal detachment in high myopia and rhegmatogenous retinal detachment with macular hole, with high closure rate of the macular hole and significant visual improvement. Key words: Retinal detachment, high myopia, macular hole; Retinal detachment, rhegmatogenous; Vitrectomy; Peeling, internal limiting membrane