June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
25-gauge Vitrectomy For Macular Holes With And Without Retinal Detachment In Highly Myopic Eyes
Author Affiliations & Notes
  • Francesco Boscia
    Ophthalmology, University of Bari, Bari, Italy
  • Nicola Recchimurzo
    Ophthalmology, University of Bari, Bari, Italy
  • Luigi Sborgia
    Ophthalmology, University of Bari, Bari, Italy
  • Ermete Giancipoli
    Ophthalmology, University of Bari, Bari, Italy
  • Claudio Furino
    Ophthalmology, University of Bari, Bari, Italy
  • Footnotes
    Commercial Relationships Francesco Boscia, None; Nicola Recchimurzo, None; Luigi Sborgia, None; Ermete Giancipoli, None; Claudio Furino, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3317. doi:
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      Francesco Boscia, Nicola Recchimurzo, Luigi Sborgia, Ermete Giancipoli, Claudio Furino; 25-gauge Vitrectomy For Macular Holes With And Without Retinal Detachment In Highly Myopic Eyes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3317.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate the surgical outcome of 25-gauge pars plana vitrectomy (PPV) for macular holes (MH) in highly myopic eyes, with and without retinal detachment (RD).

Methods: Fourteen consecutive highly myopic eyes with MH, with and without RD, were retrospectively studied. Outcome measures were visual acuity (VA), closure of MH, anatomical retinal reattachment, SD-OCT findings, and complications. Mean patients’ age was 59.2 years (range 40-77). Mean preoperative VA was 0.45±0.68 log MAR. Mean refractive error was -13.15 (range -6 to -22.0 diopters). Mean axial length was 29.4±2.9 mm. In all cases 25-gauge PPV (Constellation, Alcon) was performed with triamcinolone visualization. Premacular membrane peeling and ICG-assisted ILM peeling were carried out. Tamponading agents were in 4 cases SF6 24%, in 5 cases air, and in the others silicone oil 1000 cs.

Results: After a follow-up of 6.14±1 months (range 4-9), VA was preserved (pre-op 0.45±0.68 log MAR, post-op 0.3±0.43 log MAR, p=0.15). Anatomical flattening of the macular hole, confirmed by SD-OCT, and successful retinal reattachment were achieved in all eyes. In 3 eyes the MH remained open. IOP was stable during the whole follow-up (pre-op 14.55±3.17 mmHg, post-op 16±7.22 mmHg, p=0.55). Patients with photoreceptor layer disruption had significantly worse final best-corrected VA (P = 0.035, 0.005). None of the patients had hypotony (≤5 mmHg), choroidal detachment or endophthalmitis

Conclusions: Twenty-five-gauge transconjunctival sutureless PPV showed favorable results for the management of myopic macular hole with or without retinal detachment. Photoreceptor layer defects on SD-OCT persist despite surgery, limiting visual outcome

Keywords: 586 macular holes • 605 myopia • 762 vitreoretinal surgery  
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