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Treatments of macular hole retinal detachment in high myopia ---Comparison of gas tamponade and vitrectomy with or without internal limiting membrane peeling |
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| Treatments of macular hole retinal detachment in high myopia ---Comparison of gas tamponade and vitrectomy with or without internal limiting membrane peeling |
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作者：Jorn-Hon… 文章来源：1.3.Cheng Hsin General Hospital, Taipei, Taiwan 2. Department of Ophthalmology, Veterans General Hospital, Taipei, Taiwan 点击数：3858 更新时间：2006/7/11 17:49:49 
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| Purpose: To evaluate and compare the functional and anatomical results of three techniques: liquid vitreous-gas exchange (VGE)(group 1), vitrectomy without (group 2) and with (group 3) internal limiting membrane (ILM) peeling for the treatment of macular hole retinal detachment in patients with high myopia.
Methods: Retrospective review of medical records of patients undergoing surgical repair. Demographic data, visual acuity, extent of retinal detachment, axial length, postoperative optical coherent tomography (OCT) were collected and analyzed.
Results: Macular reattachment achieved in 10/19 cases (55.5%) in group 1, 20/24(83.3%) in group 2, 18/19(94.7%)in group 3, after one to three procedures. The visual acuity remained the same in 23 cases, improved in 24, worse in 16. The extents of visual outcome in the cases of anatomical success were not different among 3 groups. The age, sex, preoperative visual acuity and axial length, extent of detachment did not affect the anatomical outcome. The severity of myopia, axial length, and preoperative visual acuity were the prognostic factors for visual recovery. OCT examination on 18 cases of macular reattachment revealed complete closure of hole with regained foveal pit in 12, while flat hole with sealed edge in 6 cases. Closed hole was noted more frequently in group3, 7 out of 7 cases (100%) VS 1 out of 4 (25%) in group 1 and 4 out of 7 (57.1%) in group 2.
Conclusions: vitrcectomy with or without ILM peeling had fairly good surgical results. While that with ILM peeling had even higher successful rates in macular reattachment and macular hole closure. In selected cases the liquid vitreous-gas exchange technique may serve as an alternative to vitrectomy but had much higher recurrent rate.
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