Abstract
Abstract: :
Purpose:To examine the efficacy of removing the posterior vitreous membrane (PVM), which was visualized with intravitreal injection of triamcinolone, as an adjunctive treatment for macular-hole induced retinal detachment in highly myopic eyes. Methods: After surgically induced posterior vitreous detachment (PVD) was confirmed by the glial ring separation from the optic disc, the internal limiting membrane (ILM) and overlying PVM were removed in the macular area. The following intravitreal injection of triamcinolone clearly visualized the PVM where ILM with PVM had not been removed. Then only the PVM was removed further towards the ora serrata. The excised PVM was examined by a transmission electronmicroscopy. Results: In 5 of the 6 eyes the retina was reattached during the initial surgery. Redetachment of the retina occurred in one eye, which was successfully treated during the second surgery with silicone oil injection. An ultrastructural examination showed that vitreous tissue was present in all 6 specimens. Conclusion: Tangential traction by the PVM could be one of the causes of the redetachment of the retina which has been successfully treated by vitrectomy. In all 6 highly myopic eyes vitrectomized, the PVM was visualized on the surface of the retina by intravitreal triamcinolone injection, even after the PVD was mechanically induced. Triamcinolone assisted removal of the PVM could result in better reattachment rate for the detached retina resulting from a macular hole in highly myopic eyes.
Keywords: 563 retinal detachment • 628 vitreoretinal surgery • 461 macular holes