title: Scleral imbrication combined with vitrectomy and gas tamponade for refractory macular hole retinal detachment associated with high myopia.
abstract: OBJECTIVE
  To evaluate scleral imbrication with vitrectomy and gas tamponade for refractory macular hole retinal detachment associated with high myopia.
  
  
  METHODS
  We retrospectively reviewed the medical records of eight eyes with macular hole retinal detachment and high myopia treated with temporal scleral imbrication, pars plana vitrectomy, and gas tamponade for refractory macular hole retinal detachment with history of pars plana vitrectomy. Retinal reattachment and macular hole closure were assessed. Postoperative changes in axial length and surgically induced astigmatism were evaluated.
  
  
  RESULTS
  The retinas were reattached in all eyes and the macular holes closed in 6 (75%) eyes. The mean baseline logarithm of the minimum angle of resolution best-corrected visual acuity of 1.43 ± 0.48 significantly (P < 0.01) improved to 0.87 ± 0.34 at the final visit (889 ± 173 postoperative days). The mean baseline axial length of 29.5 ± 1.3 mm decreased significantly (P < 0.01) to 27.1 ± 1.9 mm 1 month after scleral imbrication and 28.1 ± 1.7 mm at the final visit (P < 0.05 vs. baseline, P = 0.13 vs. 1 month). The mean 1-month surgically induced astigmatism of 3.6 ± 1.4 diopters (D) after scleral imbrication significantly (P < 0.05) decreased to 2.4 ± 1.5 D at the final visit.
  
  
  CONCLUSIONS
  Scleral imbrication with vitrectomy and gas tamponade resulted in high reattachment and macular hole closure rates for treating refractory macular hole retinal detachment.
authors: Department of Ophthalmology, Shiga University of Medical Science, Otsu, Japan.
authors: Masato
authors: M
authors: Fujikawa
authors: Hajime
authors: H
authors: Kawamura
authors: Masashi
authors: M
authors: Kakinoki
authors: Osamu
authors: O
authors: Sawada
authors: Tomoko
authors: T
authors: Sawada
authors: Yoshitsugu
authors: Y
authors: Saishin
authors: Masahito
authors: M
authors: Ohji
mesh_terms: D000368:Aged; D058450:Endotamponade; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D016684:Prone Position; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D013536:Suture Techniques; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*
chemical_list: D013459:Sulfur Hexafluoride