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Y.–P. Chen, C.–C. Lai, T.–L. Chen, K.–J. Chen, L. Yeung, N.–K. Wang; The Influence of Posterior Staphyloma on Surgical Outcome of Retinal Detachment Resulting From Macular Hole . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4211.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the surgical outcome of retinal detachment resulting from macular hole with or without posterior staphyloma in highly myopic eyes.
The study is a retrospective review of 61 eyes of 61 consecutive highly myopic patients with or without posterior staphyloma (50 women, 11 men) who underwent initial surgery to treat retinal detachment resulting from a macular hole. Retinal detachment resulting from a macular hole was established clinically by a detailed ocular examination. The presence of staphyloma and the extent of the retinal detachment were determined by fundus examination and B–mode echography.All patients received standard pars plana vitrectomy and were followed up at least six months. Postoperative variables recorded at examination included the anatomic result, best–corrected VA, duration of follow–up time, and postoperative complications. The final anatomic outcome was regarded as successful if the retina was totally reattached.
There are thirty–three patients with posterior staphyloma (8 males, 25 females), and twenty–eight patients without posterior staphyloma (3 males, 25 females). Anatomic reattachment was achieved in 16 eyes (48.48%) of posterior staphyloma group, and in 15 eyes (53.57%) of non–posterior staphyloma group after first surgery. Visual acuity increased in 9 eyes (27.3%), remained unchanged in 13 eyes (39.4%), and deteriorated in 10 eyes (33.3%) of the staphyloma group. Visual acuity increased in 12 eyes (42.9%), remained unchanged in 10 eyes (35.7%), and deteriorated in 6 eyes (21.4%) of the non–staphyloma group.
The presence of posterior staphyloma with marked chorioretinal atrophy that led to reduced natural retinal adhesion may represent the worse condition of macular hole related retinal detachment. While treating retinal detachment resulting from macular hole, clarifying the presence of posterior staphyloma is important. If posterior staphyloma exists, the retina has to be reattached not only along the normal contour of the globe, but additionally to the curvature of the posterior staphyloma, and more aggressive treatment such as silicone oil should be performed. Failure to initiate aggressive treatment can result in an unsatisfactory outcome and repeated surgery.
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