| Objective:To analyze the clinical characteristics of high myopic macular hole（HMMH）and study the related factors affecting the prognosis of surgical treatment in patients with HMMH.Methods:The data of 80 patients with high myopia macular hole from January 2018 to August 2021 were collected and analyzed retrospectively.The age,sex,eye category,best corrected visual acuity（BCVA）,preoperative intraocular pressure,axial length,lens condition,tamponade,whether the internal limiting membrane was peeled during the operation,postoperative best corrected visual acuity and postoperative intraocular pressure were recorded.The selected patients were examined in detail before operation,1 month and 3 months after operation,mainly including BCVA,intraocular pressure（IOP）,angle of anterior chamber and Slit lamp anterior segment examination,slit lamp combined with 90 d front mirror fundus examination after mydriasis,trihedroscopy,color fundus photography,color ultrasound examination,axial length examination and OCT examination.The measurement indexes of OCT examination were: the size and shape of the hole before operation and the type of hole closure after operation.According to the type of hole closure after operation,it was divided into closed group and unclosed group;According to with or without combination of retinal detachment before operation,they were divided into two groups: group with retinal detachment and group without retinal detachment;According to different temponade,it is divided into gas temponade group and oil temponade group;They were divided into > 400 um group and ≤ 400 um group according to the diameter of the hole.The data were statistically analyzed.result:Among the 80 patients,there were 15 males（18.8%）and 65 females（81.3%）,aged from 33 to 82 years,with an average of 59.75 ± 10.49 years.There were 39 right eyes（48.8%）and 41 left eyes（51.3%）.The average axial length was 28.39 ± 2.46 mm,the average hole diameter was 836.70 ± 682.23 um,31 V-shaped holes（38.8%）and 49 Ashaped holes（61.3%）.After operation,44 cases（55.0%）healed,21 cases（26.2%）improved and 15 cases（18.8%）did not heal.There was no significant difference in hole closure between retinal detachment group and non detachment group（P > 0.05）.The prognosis of patients with retinal detachment group after macular hole surgery was related to whether internal limiting membrane peeling was performed or not,indicating that the effect of internal limiting membrane peeling in high myopia MHRD was better;There was no significant difference in macular hole closure between oil temponade group and gas temponade group,P > 0.05;There was no significant difference between the group with hole diameter>400um and the group with hole diameter ≤400um（P>0.05）.There was no significant difference in age,sex,eye category,axial length,temponade and internal limiting membrane peeling between the macular hole closed and macular hole unclosed group after macular hole surgery,but there was significant difference in hole diameter,hole shape,lens surgery and preoperative visual acuity（P < 0.05）.Multivariate analysis showed that compared with the good prognosis group,the poor prognosis group had significant difference in hole diameter,hole shape and intraocular lens surgery（P <0.05）,indicating that the prognosis of hole closure was related to hole diameter,hole shape and intraocular lens surgery.Conclusion:1.Hole diameter and hole shape are the factors affecting the healing of high myopia macular hole after surgery.2.Cataract surgery is one of the factors that affects the healing of high myopia macular hole after surgery.3.In patients with retinal detachment,internal limiting membrane peeling is one of the factors affecting the postoperative healing of high myopia macular hole.4.Age,sex,eye type,intraocular pressure,axial length and temponade were not the factors affecting the prognosis of high myopia macular hole surgery. |
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