title: Prognostic factor analysis of vitrectomy for retinal detachment associated with myopic macular holes.
abstract: OBJECTIVE
  To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  All patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center.
  
  
  METHODS
  Case records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting membrane peeling, tamponade choice, and concurrent scleral buckling, were constructed to assess associations with covariates.
  
  
  METHODS
  Retinal reattachment and complete anatomic success (retinal reattachment with MH closure).
  
  
  RESULTS
  In total, 114 subjects were analyzed. Most were women (n = 79 [69.3%]), and the mean age was 57.5±13.3 years. The mean SE was -9.88±6.37 diopters. At 6 months, 98 subjects (86.0%) demonstrated retinal reattachment, of whom 93 subjects required only 1 operation. Complete anatomic success was achieved in 61 subjects (53.5%), of whom 55 needed only 1 operation. Subjects with retinal reattachment had better best-corrected visual acuity (BCVA; mean BCVA, 1.22±0.81 logarithm of the minimum angle of resolution [logMAR] units) than those without (mean BCVA, 1.98±1.26 logMAR units; P < 0.001), and subjects with complete anatomic success had better BCVA (mean BCVA, 1.05±0.87 logMAR units) than those without (mean BCVA, 1.62±0.87 logMAR units; P < 0.001). In multivariate analyses, increasing age and the use of perfluoropropane (C3F8) tamponade were predictive of anatomic success (per 1-year increase: odds ratio [OR], 1.049; 95% confidence interval [CI], 1.002-1.099; P = 0.04; and for tamponade: OR, 10.71; 95% CI, 1.08-106.29; P = 0.04).
  
  
  CONCLUSIONS
  Vitrectomy is effective in the repair of RD resulting from MH in myopic eyes, with retinal reattachment achieved more frequently than MH closure. Retinal reattachment and MH closure are important for improving visual outcomes. Greater age at presentation and use of C3F8 are associated with a greater likelihood of anatomic success.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Department of Ophthalmology, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: Laurence Shen
authors.initials: LS
authors.lastname: Lim
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tsai
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors.forename: Doric
authors.initials: D
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors.forename: Edmund
authors.initials: E
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors.forename: Ian
authors.initials: I
authors.lastname: Yeo
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors.forename: Boon Kwang
authors.initials: BK
authors.lastname: Loh
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors.forename: Chong Lye
authors.initials: CL
authors.lastname: Ang
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
authors.forename: Sze Guan
authors.initials: SG
authors.lastname: Ong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS Graduate Medical School, Singapore, Republic of Singapore. Electronic address: lee.shu.yen@snec.com.sg.
authors.forename: Shu Yen
authors.initials: SY
authors.lastname: Lee
mesh_terms: D058450:Endotamponade; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D011379:Prognosis; D012160:Retina / Q000503:physiopathology; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy