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Y.–P. Chen, C.–C. Lai, T.–L. Chen, K.–R. Yang, Y.–H. Kuo, A.–N. Chao, W.–C. Wu, K.–J. Chen; Treatment of Retinal Detachment Resulting From Posterior Staphyloma–associated Macular Hole in Highly Myopic Eyes . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5527.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the surgical outcome of retinal detachment resulting from posterior staphyloma–associated macular hole in highly myopic eyes. Methods: Fifty–seven consecutive highly myopic eyes with retinal detachment resulting from a macular hole associated with posterior staphyloma diagnosed between January 1993 and June 2003 were retrospectively studied. Anatomic reattachment of the retina and best–corrected visual acuity were measured. Results: Six different operation methods were used to treat this condition with diverse retinal reattachment rate. They were long–acting gas tamponade only (12.5% ), pars plana vitrectomy (PPV) with long–acting gas tamponade(42.8%), PPV with epiretinal membrane (ERM) peeling and long–acting gas tamponade (50.0%), encircling scleral buckle (SB) combined PPV with long–acting gas tamponade (57.1%), encircling SB combined PPV with ERM peeling and long–acting gas tamponade (40.0%), and encircling SB combined PPV with silicone oil tamponade (75.0%). Overall successful retinal reattachment was achieved in 25 of 57 eyes (43.9%) after the first surgery. However, the ultimate successful retinal reattachment rate was 77.2% (44 of 57 eyes) after subsequent surgery. The average preoperative visual acuity in log MAR values was 2.08± 0.55 and postoperative visual acuity was significantly increased to 1.87± 0.54 at the last follow–up (P=0.038). There was no obvious correlation between the extent of the detachment and the reattachment rate. Conclusions: Long–acting gas tamponade alone is insufficient to achieve satisfactory results in the treatment of retinal detachment resulting from posterior staphyloma–associated macular hole in highly myopic eyes. Furthermore, a lesser extent of retina detachment is not associated with a better anatomic success rate. Pars plana vitrectomy combined with complete epiretinal membrane peeling and silicone oil tamponade may overcome not only vitreoretinal and tangential macular traction, but also the curvature of posterior staphyloma, resulting in a higher success rate.
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