Surgical management of retinal detachment in highly myopic eyes with macular hole.
To evaluate the visual and anatomical outcomes of surgery for retinal detachment due to macular hole in highly myopic eyes with pronounced posterior staphyloma.



Data for all patients with high myopia who underwent surgery for retinal detachment resulting from macular hole from 1993 to 2002 in one hospital were evaluated. Patient characteristics, best-corrected visual acuity preoperatively and at last examination, surgical technique, anatomical success, and follow-up period were extracted and analyzed statistically.



Twenty-six of the 27 patients (28 eyes) were female (96%) with a mean age of 59.8 years; mean follow-up was 17.3 months. Mean axial length was 29.1+/-2.74 mm; mean myopia was -16.4 +/- 3.1 diopters. Marked posterior staphyloma was detected in 71%. Seven eyes had undergone failed scleral buckling as the primary procedure; intravitreal SF6 injection was the primary procedure in 12 eyes. Twenty-three eyes underwent deep vitrectomy with use of high viscosity silicone oil. Overall anatomical success was achieved in 92.9% (26 of 28 eyes); 78.6% had visual improvement.



Vitreous surgery combined with other necessary adjunct procedures such as membrane peeling and use of retinal tamponade, as a primary or a secondary procedure, seems to be successful in achieving retinal reattachment in eyes with macular hole and posterior staphyloma.
Soheilian
Masoud
M
Ophthalmology Department, Ophthalmic Research Center (MS, AKG, SY HA, MA, MHD, SM, AA), Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Ghaseminejad
Amir K
AK
Yazdani
Shahin
S
Ahmadieh
Hamid
H
Azarmina
Mohsen
M
Dehghan
Mohammad H
MH
Moradian
Siamak
S
Anisian
Arash
A
Peyman
Gholam A
GA
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications* / Q000503:physiopathology; D012029:Refraction, Ocular; D012163:Retinal Detachment / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012167:Retinal Perforations / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods*; D012720:Severity of Illness Index; D012827:Silicone Oils / Q000008:administration & dosage; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body
D012827:Silicone Oils; D013459:Sulfur Hexafluoride