Primary gas tamponade in the management of macular hole with retinal detachment in highly myopic eyes

Abstract

Background We conducted a retrospective study to investigate the role of the primary gas tamponade on the final success rate of macular hole with retinal detachment (MHRD) in highly myopic eyes. Methods Retrospective chart review of the patients diagnosed as MHRD in highly myopic eyes between 1992 and 2008 was done. Fifty-three highly myopic eyes (>−6.0 diopter, >26 mm of axial length, or visible posterior staphyloma) with a retinal detachment resulting from a macular hole were included. The main outcome measures were anatomic reattachment and final visual acuity. Results Thirty-two of the 53 eyes received primary gas tamponade, and the reattachment of retina was achieved in 8 eyes (8/32, 25%). Twenty-one of the 53 eyes received primary pars plana vitrectomy (PPV) with or without scleral buckle, and the reattachment of retina was achieved in 12 eyes (12/21, 57.1%). The final success rate after adjunctive operations was 96.9% in the primary gas tamponade group, and 85.7% in the primary PPV group. Stability of vision (improved or maintained) was achieved in 78.1% of the primary gas group, and 66.7% in the primary PPV group. Conclusion Our results indicate that primary gas tamponade does not decrease the final success rate in the repair of MHRD in highly myopic patients. Since it is safe and time-saving, primary gas tamponade could be a good alternative for primary treatment in those who are not willing or eligible for more complicated surgeries.