Surgical Management Of Retinal Detachment Associated With Myopic Macular Hole-

PurposeTo evaluate the feasibility and efficacy of macular buckling combined with internal limiting membrane removal and gas tamponade with perfluoropropane injection for macular hole related retinal detachment in patients with severe myopia.Materials and methodsDuring June2011and June2012,10eyes with retinal detachment associated with a myopic macular hole were performed macular buckling combined with pars plana vitrectomy, internal limiting membrane peeling and gas tamponade were studied prospectively. All patients with ocular axial length over27.0mm, fundus examination had macular retinal detachment or macular detachment with inferior retinal detachment. Full thickness macular hole was confirmed by optical coherence tomography. Retinal detachment with long time or inflexible was excluded. All patients received macular buckling combined with pars plana vitrectomy, internal limiting membrane peeling and gas tamponade at the same time. Postoperative follow-up was6-18months.postoperative retinal status, macular hole closing rate,visual acuity were recorded and analyzed.Results(1) retinal reattachmentThe retina reattached in the10eyes following the initial surgery (100%). Retinal detachment occurred in one eye (10%) one month after the initial surgery, and gas tamponade was done again with perfluoropropane, the retina was reattached, but the macular hole contained opened.(2) the postoperative status of the macular hole OCT:The macular hole was anatomically closed in five eyes and was partially closed in five eyes, still some tissue defect in the macular center.(3) postoperative visual acuityVisual acuity remained unchanged in one eyes (10%), and improved by two or more measurement in nine eyes (90%).(4) complications of surgeryNo iatrogenic retinal holes formed in the operation. Postoperative vitreous hemorrhage in1eye but resolved2weeks after surgery. No endophalmitis happened postoperatively.Conclusions:macular buckling combined with pars plana vitrectomy, internal limiting membrane peeling and gas tamponade with perfluoropropane is a safe and effective surgical treatment for macular hole related retinal detachment in patients with severe myopia.