Surgical management of retinal detachment associated with myopic macular hole: anatomic and functional status of the macula

Macular Hole Closure Over Residual Subretinal Fluid by an Inverted Internal Limiting Membrane Flap Technique in Patients With Macular Hole Retinal Detachment in High Myopia

“…Kuriyama et al 9 reported that both the initial retinal reattachment rate and the macular hole closure rate after pars plana vitrectomy using the inverted ILM flap technique for MHRD were 75% (3 of 4 eyes). No head-to-head comparative study with the conventional ILM peeling technique has been made so far, and the closure rate of their study, 75%, is comparable with previous reports ranging from 10% to 91% [1][2][3][4][5][6] However, this technique is supposed to allow a higher success rate, as in nonhighly myopic eyes. Our results also indicate that reattachment of the retina may not be necessary for closure of macular holes and that this finding can only be seen when the inverted ILM technique has been used.…”

Anatomical and Visual Outcomes After Episcleral Macular Buckling Compared With Those After Pars Plana Vitrectomy for Retinal Detachment Caused by Macular Hole in Highly Myopic Eyes

“…As regards OCT findings after PPV for complicated macular hole-caused retinal detachment in highly myopic eyes, Kobayashi et al 19 reported their experience with 10 eyes undergoing PPV; only 3 eyes achieved macular hole closure, whereas the other 7 showed patent macular hole. Ichibe et al 20 reported that only 1 of 10 eyes undergoing PPV combined with internal limiting membrane peeling achieved macular hole closure when evaluated by OCT. Ikuno et al 21 reported that 7 of 16 eyes undergoing PPV had macular hole closure when evaluated by OCT. Thus, the previously reported data suggest at the level of OCT images to document the detailed foveal appearance that EMB is more effective than PPV in anatomical closure of macular hole in highly myopic eyes with posterior staphyloma.…”

Recent trends in the management of maculopathy secondary to pathological myopia

“…Reported closure rates also vary significantly if OCT is not used as part of the macular assessment [87][88][89]. Furthermore, post operative MH enlargement has been reported, supporting the theory that the imbalance between the retina and choroid-sclera complex due to the posterior staphyloma may need to be remedied for the complete relief of traction [85]. Whilst MH closure rates are poor, retinal reattachment rates following vitrectomy surgery are thought to be more successful, varying between 40 and 93% [85,90].…”

“…Pars plana vitrectomy (PPV) in combination with inner limiting membrane (ILM) peel and a long-or short-acting gas tamponade is commonly used to repair MH. Reported closure rates using the above approaches vary between 10% and 44% in studies that have used OCT to evaluate MH closure in high myopes [84,85]. Poor anatomic outcomes are thought to result from inner retinal shortening, which is not fully compensated for by ILM peeling and does not provide sufficient redundant retina [86].…”