First Author: Y.Kung TAIWAN
Co Author(s): T. Wu
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We evaluated surgical outcomes in eyes with extremely high myopia for macular hole (MH) without retinal detachment (RD).
14 consecutive eyes with axial lengths of ≥30.0 mm underwent vitrectomy and internal limiting membrane (ILM) peeling with or without inverted ILM flap insertion for MH without RD (October 2009-June 2016). Outcome measures were MH closure, visual acuity (VA), and complications.
The mean axial length was 30.69 ± 0.76 mm. The overall final closure rate was 85.7% (12/14 eyes); the mean follow-up was 17.29 (±20.20) months. Primary anatomic MH closure after 1 operation was achieved in 3 of 8 eyes (37.5%) without an inverted ILM flap and was achieved in 6 of 6 eyes (100%) with inverted ILM flap insertion (P = 0.031). Mean best-corrected VA improved significantly from 1.10 ± 0.43 LogMAR to 0.84 ± 0.50 LogMAR (P = 0.046; 2-tailed, paired t test). Only 1 eye developed an MH-associated RD 4.5 years after previously failed MH surgery; re-attachment was achieved after a second operation.
Patients with extremely high myopia may obtain anatomical and functional improvements from MH surgery; inverted ILM flap insertion may achieve significantly higher primary success rates in MH closure.