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T. M. Dzhusoev, Jr., Y. V. Bayborodov, Jr.; Microinvasive Vitrectomy for Macular Holes in High Myopia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2270.
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Variety of surgical strategies for macular holes (MH) in high myopia indicates importance of this problem. Scleral buckling and sclera ballooning are not the best methods of choice since they do not provide closure of the MH edges and thus cannot guarantee successful restoration of visual acuity. Purpose of this study was to evaluate the effectiveness of surgical treatments for myopic MH and determine optimal surgical and post-operative strategies in patients with high myopia.
Study included 30 myopes (5.0 diopters and higher; anterior-posterior eye axis length of 26 mm and greater) with MH no more than 600 micron in diameter. Mean (±St.Dev.) visual acuity (VA) was 0.1 ± 0.09. In all patients, 25G vitrectomy was performed. Removal of the central part of the vitreous was followed by intravitreal kenalog injection, circumferential peeling of the inner limiting membrane (ILM) without staining, and gas-air tamponade. If peripheral retinal tears were present, scleral silicone banding and laser coagulation of the retina were performed. Prone position was required for three days after the surgery. Patients were followed with measurements of VA, visual fields, intraocular pressure, optical coherent tomography (OCT) and fundus photography before and for one year after the surgery.
Criteria for the MH closure were full convergence of the hole edges and no anatomical defects of neuroepithelium. Ten days after the surgery, OCT showed MH closure in 29 patients. During the one-year follow-up period, all patients underwent cataract extraction on the operated eye; no retinal detachment or recurrent MH was observed. Mean (±St.Dev.) VA at the end of the follow-up period was 0.4 ± 0.12.
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