Treatment of retinal detachment resulting from myopic macular hole with internal limiting membrane removal.
OBJECTIVE
To examine the efficacy of vitrectomy with internal limiting membrane removal for retinal detachment resulting from a macular hole in highly myopic eyes.


METHODS
Eleven consecutive highly myopic eyes (11 patients) with retinal detachment resulting from a macular hole were treated by vitrectomy with removal of the internal limiting membrane, which was stained with indocyanine green and sulfur hexafluoride gas injection. Postoperatively, the patients were instructed to remain prone for 2 weeks. The excised specimens were evaluated with transmission electron microscopy.


RESULTS
The mean postoperative follow-up was 9.2 +/- 2.3 months (range, 7 to 13 months). In 10 of the 11 eyes (91%) the retina was reattached during the initial surgery. Redetachment occurred in one eye, which was successfully treated during the second surgery. Best-corrected visual acuity improved in all eyes and ranged from 20/400 to 20/50. Pathologic examination showed that the internal limiting membrane and epiretinal tissues were present in all specimens.


CONCLUSIONS
The use of indocyanine green staining can facilitate removal of a macular internal limiting membrane and overlying epiretinal membrane, resulting in complete relief of the macular traction. Primary removal of the internal limiting membrane may contribute to a high initial success rate for retinal reattachment and be an important adjuvant to the treatment of retinal detachment resulting from a macular hole in highly myopic eyes.
Department of Ophthalmology, Yokohama City University School of Medicine, 4-57 Urafune-cho Minami-ku, Yokohama 232-0024, Japan. kado@med.yokohama-cu.ac.jp
K
K
Kadonosono
F
F
Yazama
N
N
Itoh
E
E
Uchio
S
S
Nakamura
J
J
Akura
H
H
Sawada
S
S
Ohno
D000368:Aged; D001485:Basement Membrane / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D016684:Prone Position; D012008:Recurrence; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000150:complications*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D014792:Visual Acuity; D014821:Vitrectomy
D007208:Indocyanine Green; D013459:Sulfur Hexafluoride