Clinical Studyof Highly Myopia Macular Hole Retinal Detachment

PurposeTo investigate the effect of axial length on the prognosis of highly myopia macular hole with retinal detachment;to compare the postoperative effect of different intraocular tamponade;to investigate the independent risk factors of retinal detachment after initial operation and final hole closure.MethodData of patients with highly myopia macular hole retinal detachment in our hospital from January 2011 to December 2015 were analyzed retrospectively in 51 cases of 53 eyes(diopter>6D and axial length>26mm).The factors of the patients was recorded:Age,Gender,eye,diopter,axial length,crystal surgery,intraocular perfusion,the inner limiting membrane peeling,postoperative removal of silicone oil,postoperative final vision,postoperative retinal detachment rate,the closure of the hole after surgery and other data.According to the axial length(28mm,29mm,30mm as the standard)patients were divided into two groups separately,>28mm group and ? 28mm group,>29mm group and ? 29mm group and>30mm group and ? 30mm group;according to the intraocular tamponade,patients were divided into two groups:silicone oil group and C3F8 group;patients were also divided into retinal reattachmentgroup and retinal detachment after initial operation;hole closure group and hole remained open group.Statistical analysis was performed on each groupResultsAmong the 51 patients,11 were male(21.6%)and 40 were women(78.4%);aged 33-78 years,mean 60.45 ± 8.35 years old;28 right eyes(52.8%)and 25 left eyes(47.2%).The average diopter was-11.43 ± 4.22D,the average axial length was 29.19± 1.58mm,and the average time of silicone oilextraction was 8.06 ± 3.03 months.The primary retinal reattachment rate was 77.4%(41/53)and the final closure rate was 22.6%(12/53).The average preoperative visual acuity was 2.12 ± 0.46 and the mean postoperative visual acuity was 1.70 ± 0.57,P = 0,the difference was statistically significant.>28mm group and ?28mm group,>29mm group and ?29mm group,>30mm group and<30mm group,silicone oil group and C3F8 group in sex,eye,preoperative visual acuity,postoperative visual acuity,axial length,Internal limiting membrane peeling,cataract surgery,retinal reattachment rate and hole closure had no difference,P were greater than 0.05.There was also no significant difference in age,sex,preoperative visual acuity,axial length,cataract surgery,intraocular tamponade,internal limiting membrane peeling between retinal reattachmentgroup and retinal detachment after initial operation,but there was significant difference in postoperative visual acuity and hole closure,P<0.05.No clinical factors were significantly associated with the retinal reattachment and hole closure using multivariate analysis.Conclusion1.Axial length does not correlate with the reattachment of high myopia macular hole with retinal detachment and macular hole closure.2.The hole unclosure is the direct factor for the retinal detachment after initial surgery.3.The axial length does not correlate with the diameter of the macular hole in highly myopia.4.Age,gender,eye,axial length,intraocular tamponade,cataract surgery are not risk factors of highly myopia macular hole with retinal detachment.