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S Kishi, H Kobayashi, H Hashimoto; Prophylactic Vitrectomy for Highly Myopic Macular Hole Atprecursory Stage . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2471.
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Purpose: We previously reported that foveal retinal detachment and foveal retinoschisis frequently occur in highly myopic eyes with posterior staphyloma. These foveal changes appeared the precursory stage of macular hole. Macular hole in highly myopic eye is usually associated with retinal detachment and its treatment is tough and visual prognosis is poor. To evaluate the prophylactic effect of vitreous surgery for highly myopic macular hole at precursory stage. Methods:We performed vitrectomy in 6 eyes of 5 patients with foveal retinal detachment and foveal retinoschisis. All 6 eyes had severe myopia with posterior staphyloma. All patient were women and their age ranged from 36 to 74 years (mean, 56.8). Their refractive error ranged from –7.5 D to –18 D. Vitreous surgery consisted of core vitrectomy, surgical induced posterior vitreous detachment (only one eye), removal of internal limiting membrane in the posterior staphyloma and 30% SF6 gas tamponade. Patients were indicated a prone position at least one day after surgery. Results:In 5 of the 6 eyes, foveal retinal detachment and retinoschisis gradually reduced its height and finally attained foveal attachment within 6 months after vitrectomy. Postoperative visual acuity ranged from 0.2 to 0.5. On eye developed full-thickness macular hole and its postoperative visual acuity was 0.08. Conclusion:Prophylactic vitrectomy for precursory stage of highly myopic macular hole is effective in preventing macular hole formation and improvement of visual acuity.
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