Foveal Reconstruction and Central Vision Preservation in Primary Silicone Oil Tamponade Without Retinopexy in Highly Myopic Eyes With Central Macular Hole Detachments

Abstract

Purpose: : Optical coherence tomography (OCT) and automated visual field examination were performed to analyze the long-term anatomic and functional outcomes for eyes undergoing vitrectomy, internal limiting membrane (ILM) peeling, and primary silicone oil filling without central photocoagulation.

Methods: : Twenty-two patients with central macular hole detachments and myopia ranging from -9.5 to -23.0 diopters underwent vitrectomy, ILM peeling and primary silicone oil filling without laser photocoagulation of the central retina. OCT and automated visual field examination were done.

Results: : In twenty-one eyes, the retina was attached by the first postoperative day and remained attached until the end of the follow-up period. In one eye, supplementary silicone oil instillation was needed to completely tamponade the macular hole. No severe intra- or postoperative complications were noted. Visual acuity increased in 18of 22 eyes, remained unchanged in 4 of 22 eyes. OCT showed well-sealed central hole without retinal schisis or subretinal fluid. Smooth foveal depression over central retina was impressed. Foveal contour restroration was impressive and improving during the follow-up period. Automated visual field examination showed preserved central field.

Conclusions: : Vitrectomy, ILM peeling plus primary silicone oil tamponade without endophotocoagulation is an effective method to treat central macular hole detachments in high myopic eyes. In addition to restoration of foveal contour without laser damage, silicone oil as inductor and scaffold for long-term glial closure of the macular hole might contribute to the preservation of central vision.

Keywords: retinal detachment • myopia • macular holes