The role of vitreoretinal surgery in the management of myopic macular hole without retinal detachment.
OBJECTIVE
To evaluate the anatomic and functional outcome of vitreoretinal surgery in eyes with pathologic myopia and macular hole and to determine if surgery improves visual acuity.


METHODS
Twenty-four consecutive highly myopic eyes with full-thickness macular hole without posterior retinal detachment were treated by vitrectomy. Posterior hyaloid dissection, removal of epiretinal and internal limiting membranes (ILM) if thickened, instillation of platelet concentrate, and flushing with 25% sulfur hexafluoride were performed.


RESULTS
Patients' refractive error ranged between -8.0 and -17.5 diopters, and axial length ranged from 27.1 to 31.4 mm. Two epimacular membranes and 10 macular ILM were removed. Ten patients also underwent phacoemulsification and intraocular lens implantation at the same procedure. Mean preoperative best-corrected visual acuity was 20/200. Successful anatomic macular hole closure occurred 6 months postoperatively in 100% of eyes after one (21 eyes, 87.5%) or two surgeries (3 eyes, 12.5%). Visual acuity improved three or more lines in 83.3% of patients. Mean postoperative visual acuity was 20/70. No retinal detachment was observed during the follow-up period, which ranged from 12 to 45 months.


CONCLUSIONS
Our results suggest that vitreoretinal surgery may effectively manage myopic macular holes, thus improving anatomic and visual outcomes. By closing the hole, vitreoretinal surgery may decrease the risk of posterior retinal detachment in highly myopic eyes.
García-Arumí
J
J
Hospital Vall d'Hebrón, Universidad Autónoma de Barcelona, Instituto de Microchirurgía Ocular, Spain. 17215jga@comb.es
Martinez
V
V
Puig
J
J
Corcostegui
B
B
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D018918:Phacoemulsification; D012163:Retinal Detachment / Q000517:prevention & control*; D012167:Retinal Perforations / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors; D013459:Sulfur Hexafluoride / Q000627:therapeutic use; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
D013459:Sulfur Hexafluoride