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Elise Philippakis, Aude Couturier, Vincent Gualino, David Gaucher, Alain Gaudric, Pascale G Massin, Ramin Tadayoni; Posterior vitreous detachment in highly myopic eyes undergoing vitrectomy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2301. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report the rate of complete posterior vitreous detachment (PVD) in highly myopic eyes requiring vitreoretinal surgery, using intraoperative observation.
A retrospective observational analysis was performed on highly myopic eyes (refractive error (RE)<-6,00D, Axial length (AL)>26mm or biomicroscopy signs of high myopia) who had undergone 25G 3-port pars plana vitrectomy in the department of Ophthalmology of Lariboisiere Hospital between 2009 and 2012. The main outcome was the intra operative evaluation of complete PVD : absence of residual posterior vitreous cortex after staining or peeling. The complete PVD was considered absent when either there was no PVD, partial PVD or remnants of posterior vitreous cortex.
Ninety six eyes of 95 patients were included. Mean age was 62,15 years (range 29-95), mean refractive error(RE) was -13,9D and mean axial length(AL) was 29,2mm. Surgical indications were epiretinal membrane (ERM), Macular Hole (MH), foveoschisis (FVS), rhegmatogenous retinal detachment (RD) or macular hole retinal detachment (MHRD). Complete PVD was identified in 52.1% of eyes. This PVD rate varied widely among diseases. It was higher in RD and ERM (85% and 74.2% respectively) and lower in FVS and MH (14.3% and 10% respectively). It was 42.9% in MHRD. In the whole population of eyes, no statistical influence of gender, age, AL or lens status on PVD rate was found.
This is the first study reporting the PVD rate in highly myopic eyes using intraoperative examination. We reported a complete PVD rate of 52.1%. This rate appears to be lower than the complete PVD prevalence previously estimated by biomicroscopic examination and macular SD-OCT . However, this PVD rate varied widely among diseases. In RD and ERM, the reported rate was high and similar to PVD rate of emmetropic eyes. In FVS and MH, posterior vitreous cortex was attached in the vast majority of eyes.
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