The Role of Vitreoretinal Surgery in the Management of Myopic Macular Hole Without Retinal Detachment

Abstract

Our results suggest that vitreoretinal surgery may effectively manage myopic macular holes, thus improving anatomic and visual outcomes. By closing the hole, vitreoretinal surgery may decrease the risk of posterior retinal detachment in highly myopic eyes.

Comparison of anatomical and visual outcomes of macular hole surgery in patients with high myopia vs. non-high myopia: a case-control study using optical coherence tomography

“…Earlier stages and shorter durations of symptoms, especially less than 6 months, were associated with better surgical outcomes [4,12,13,17,18]. However, there is still no consensus as to whether high myopia is associated with relatively poor prognosis [5][6][7][8][9].…”

“…In a case series of high myopia with macular hole, García-Arumí et al [5] reported an 87.5% primary anatomical closure rate after operation, while Patel et al reported a rate of only 60% with a single operation in highly myopic eyes [6]. Case-control studies by Sulkes et al., Kobayashi et al, and Kwok et al did not reveal significant differences in macular hole closure rates between highly myopic and non-highly myopic eyes [7][8][9].…”

“…Case-control studies by Sulkes et al., Kobayashi et al, and Kwok et al did not reveal significant differences in macular hole closure rates between highly myopic and non-highly myopic eyes [7][8][9]. However, they all used biomicroscopy alone to evaluate the results and defined only flattening of the edges or resolution of cuff of subretinal fluid as surgical success [5][6][7][8][9]. They did not use optical coherence tomography (OCT) to confirm complete closure, which may be difficult to diagnose clinically with biomicroscopy alone in highly myopic eyes.…”

Macular Hole Repair by Vitrectomy and Internal Limiting Membrane Peeling in Highly Myopic Eyes

“…28,29 In this study, ILM peeling was performed in all cases, and 87% of the eyes had successful closure of MH after one operation, which was similar to the results of other studies (from 87.5% to 100%). 10,12,13 Vitrectomy with ILM peeling appeared to attain higher anatomical closure rates compared with surgery without ILM peeling. In addition, Kuriyama et al 30 reported the initial closure rates of 83.3% (5 in 6 eyes) in an inverted ILM flap technique for the treatment of MH in high myopia recently.…”

“…9 Although there have been few studies on the surgical outcomes of MH in highly myopic eyes using this standard procedure, [10][11][12][13] these studies have reported variable surgical outcomes, which might have resulted from small sample sizes, short follow-up times, and different methods to evaluate the closure of MH. 11 In addition, poorer visual outcome of MH after the surgery has been found in highly myopic patients than idiopathic MH patients.…”