title: Macular buckling for previously untreated and recurrent retinal detachment due to high myopic macular hole: a 12-month comparative study.
abstract: OBJECTIVE
  To evaluate postoperative outcomes after macular buckling together with pars plana vitrectomy (PPV) in previously untreated and recurrent retinal detachment secondary to macular hole (MH) in highly myopic eyes.
  
  
  METHODS
  In a retrospective cohort study, 42 eyes of 42 high myopic patients with retinal detachment due to MH were evaluated. Patients were divided into previously untreated retinal detachment (group 1, 21 eyes) and recurrent retinal detachment (group 2, 21 eyes). Macular buckling and PPV were performed in all patients. Main outcomes included retinal reattachment rate, macular hole closure rate and best-corrected visual acuity (BCVA) at 3, 6, and 12 months. Optical coherence tomography (OCT) was performed both pre- and postoperatively in all patients to assess the anatomical status of the macula.
  
  
  RESULTS
  Primary retinal reattachment rate in group 1 was 95% (20/21), which increased to 100% (21/21) after a second surgery. MH closure was achieved in 81% of patients (17/21) after one surgery. The mean preoperative BCVA (logarithm of the minimum angle of resolution, LogMAR) improved from 1.32 (95% CI 1.19;1.44) to 0.76 (95% CI 0.56;0.96) 12 months postoperatively. In all except one case, gas tamponade was preferred. Primary reattachment and MH closure rate in group 2 were 90.5% (19/21) and 57% (12/21) respectively, and did not improve after a second surgery. Preoperative BCVA (LogMAR) was 1.39 (95% CI 1.29;1.49) and improved to 0.95 (95% CI 0.75;1.15) at 12 months. Silicone oil tamponade was used in seven of 21 patients, and finally was removed in five of them.
  
  
  CONCLUSIONS
  Macular buckling combined with PPV should be considered a preferred surgical approach both in primary and recurrent retinal detachment secondary to MH in high myopic eyes. Nevertheless, visual outcomes seem to be better when macular buckling is chosen as first-line treatment.
authors.affiliation: IMO - Instituto de Microcirugía Ocular, Barcelona, Spain, micol_alkabes@hotmail.com.
authors.forename: Micol
authors.initials: M
authors.lastname: Alkabes
authors.forename: Anniken
authors.initials: A
authors.lastname: Burés-Jelstrup
authors.forename: Cecilia
authors.initials: C
authors.lastname: Salinas
authors.forename: Marco Dutra
authors.initials: MD
authors.lastname: Medeiros
authors.forename: José
authors.initials: J
authors.lastname: Rios
authors.forename: Borja
authors.initials: B
authors.lastname: Corcostegui
authors.forename: Carlos
authors.initials: C
authors.lastname: Mateo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D058450:Endotamponade; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D012008:Recurrence; D012086:Reoperation; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000150:complications*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy