Efficacy of internal limiting membrane peeling for macular hole retinal detachment in degenerative myopia

Abstract

Objective To observe the efficacy of vitrectomy combined with internal limiting membrane(ILM) peeling and silicone oil tamponade for the treatment of macular hole retinal detachment (MHRD) in degenerative myopia(DM), and analyze the related factors affecting the operative efficacy. Methods A retrospective analysis. Seventy-four eyes of 69 patients with DM-MHRD between April 2007 and April 2014 in the Affiliated Hospital of Wenzhou Medical University were enrolled. All patients underwent vitrectomy combined with ILM peeling and silicone oil tamponade after gas exchange, and a secend surgery to remove the oil. The follow up was at least 6 months. The changes of BCVA were compared before and after surgery. The visual acuity improved rate , the retinal reattachment, macular hole closure and postoperative complications were recorded, and the factors on macular hole closure and improvement of visual acuity were analyzed. Results The BCVA(logMAR) was (1.10±0.43), which was significantly improved compared to that before surgery (1.44±0.48) (P=0.001). Sixty-eight eyes (91.9%) demonstrated retinal reattachment, 43 eyes (58.1%) achieved the I-type of macular hole closure, and another 25 eyes (33.8%) got the II-type of macular hole closure. The visual acuity improved rate was 62.2% , which meant there were 46 eyes got better BCVA after operation. Logistic regression analysis showed that postoperative visual acuity improvement was correlation with preoperative BCVA (OR=10.680, P=0.003). After operation, MHRD recurred in 2 eyes, and the retina reattched by reoperation. Conclusion Vitrectomy combined with ILM peeling and silicone oil tamponade is an effective procedure for the treatment of DM-MHRD. Prognosis of postoperative vision depends on preoperative visual acuity. Key words: Myopia, degenerative; Retinal detachment, macular hole; Peeling, internal limiting membrane; Tamponade, silicone oil