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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. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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).
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.
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
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
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