Treatment of Retinal Detachment Secondary to Macular Hole in Highly Myopic Eyes

Lv, Meng; Wei, Wenbin; Li, Yanlong; Han, Xiaodong; Shi, Xiaobo; Yang, Min

doi:10.1097/iae.0b013e31829d004b

Cited by 23 publications

(10 citation statements)

References 28 publications

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“…1, 2, 3 Several approaches have been attempted such as macular buckling, scleral shortening, pars plana vitrectomy (PPV), and combinations thereof. 4, 5, 6 The macular buckling technique was the standard surgical treatment for MHRD before the introduction of PPV in 1982. 2, 7, 8, 9 The retinal attachment rate after macular buckling and scleral shortening ranged from 93.3 to 100%, although the macular hole closure rates after these procedures were unknown.…”

Section: Introductionmentioning

confidence: 99%

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Sasaki

Shiono

Kogo

et al. 2016

Eye

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PurposeTo determine whether the inverted internal limiting membrane (ILM) flap technique contributes to high reattachment and closure rates in patients with macular hole-associated retinal detachment (MHRD).Patients and methodsIn all, 15 eyes of 15 patients with MHRD undergoing 25-gauge pars plana vitrectomy with the inverted ILM flap technique or ILM peeling. The patients were divided into the inverted ILM flap technique group (6 eyes) and ILM peeling group (9 eyes). The logarithm of minimal angle of resolution best-corrected visual acuity (BCVA) and retinal attachment and macular hole closure rates were compared between the two groups before and after surgery.ResultsNo significant differences were found in the pre- and postoperative BCVA at 1 and 3 months after surgery in either group (inverted ILM flap technique group, preoperatively 1.04±0.55, 1 month 0.95±0.30, 3 months 0.83±0.22; ILM peeling group, preoperatively 1.00±0.44, 1 month 1.05±0.38, 3 months 1.06±0.49; P>0.05, respectively). The postoperative BCVA at 6 months after surgery was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, 0.62±0.35; ILM peeling group, 1.02±0.41, P=0.045). The improvement in BCVA was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, –0.41±0.29; ILM peeling group, 0.02±0.36; P=0.021). The primary macular hole closure rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary reattachment rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary macular hole closure and reattachment rates were not significantly different in both groups (P=0.056, respectively).ConclusionThe inverted ILM flap technique is a useful procedure for MHRD in highly myopic eyes.

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Section: Introductionmentioning

confidence: 99%

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Sasaki

Shiono

Kogo

et al. 2016

Eye

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“…Nishimura et al reported that PPV with ILM peeling and primary silicone oil tamponade without any postoperative position restrictions led to a 92 % retinal reattachment rate after the initial surgery, with a mean duration of silicone oil tamponade of 23.3 months [ 17 ]. In another study by Meng et al [ 19 ] in 21 consecutive highly myopic eyes with RD resulting from MH, the MH closure rate was 86 % and the final retinal reattachment rate was 95.2 %. However, the occurrence of chorioretinal atrophy in patients was not reported in these studies.…”

Section: Discussionmentioning

confidence: 98%

Primary silicone oil tamponade and internal limiting membrane peeling for retinal detachment due to macular hole in highly myopic eyes with chorioretinal atrophy

2015

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BackgroundRetinal detachment (RD) secondary to macular hole (MH) is a common complication in highly myopic eyes, usually leading to a poor visual prognosis. The purpose of this study was to evaluate the surgical outcome of silicone oil (SO) tamponade and internal limiting membrane (ILM) peeling in the treatment of RD caused by MH (MHRD) in highly myopic eyes with chorioretinal atrophy, and to identify clinical factors associated with the anatomical outcomes.MethodsWe retrospectively reviewed 21 eyes of 21 highly myopic patients affected by RD secondary to MH and chorioretinal atrophy. All eyes were treated with pars plana vitrectomy (PPV) with ILM peeling and SO tamponade. Anatomical success was defined as reattachment of the retina with the closure of the MH, as assessed by optical coherence tomography (OCT), after SO removal. Logistic regression was performed to determine the clinical factors influencing anatomical success.ResultsThe mean patient age was 59.95 years [standard deviation (SD), 10.39; range, 34–77 years] and the mean axial length was 30.58 mm (SD, 1.52; range, 27.99–34.51 mm). After the first surgical procedure, the anatomical success rate was 61.9 % (13 eyes in 21 eyes), with initial retinal attachment of16 eyes (76.2 %). A second surgical approach was performed for the five eyes with persistent or recurrent RD, and the final retinal reattachment rate was 100 % (21/21). Logistic regression analysis showed that no specific factors were significantly associated with anatomical success.ConclusionsPrimary silicone oil tamponade and ILM peeling can be a practical treatment for repairing MHRD in highly myopic eyes with chorioretinal atrophy.

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“…Conventional approaches, including macular buckling, scleral shortening, and scleral imbrication, have been attempted to improve the surgical outcomes of eyes with MHRD [5][6][7]. With the introduction of pars plana vitrectomy (PPV) for the treatment of idiopathic MH, vitrectomy with removal of the cortical vitreous and internal limiting membrane (ILM) or gas tamponade has been widely accepted as the standard treatment for MHRD [8,9].…”

Section: Introductionmentioning

confidence: 99%

Inverted Internal Limiting Membrane Flap Technique versus Internal Limiting Membrane Peeling for Vitrectomy in Highly Myopic Eyes with Macular Hole-Induced Retinal Detachment: An Updated Meta-Analysis

Ling

Liu

et al. 2020

Journal of Ophthalmology

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Background. The aim of this meta-analysis was to compare morphological and functional outcomes between vitrectomy with the inverted internal limiting membrane (ILM) flap technique and vitrectomy with internal limiting membrane peeling in highly myopic eyes with macular hole- (MH-) induced retinal detachment (MHRD). Methods. The PubMed, Web of Science, Embase, and Cochrane Library databases were comprehensively searched from inception to November 10, 2019, for published studies comparing the two techniques for the treatment of MHRD. The outcomes in the collected articles included the postoperative MH closure rate, retinal reattachment rate, and best-corrected visual acuity (BCVA). Review Manager (version 5.3) was used for analyses. Results. In total, seven retrospective studies comparing the inverted ILM flap technique with ILM peeling for the treatment of MHRD were included. The MH closure rate was significantly higher in the inverted ILM flap group than in the ILM peeling group at 6 and 12 months after initial surgery (OR = 15.39; 95% CI: 6.68 to 35.43;P<0.00001 and OR = 12.58, 95% CI: 3.51 to 45.08; P=0.0001), while the retinal reattachment rate was similar in both groups at 6 months after initial surgery (OR = 2.40; 95% CI: 0.89 to 6.50; P=0.08). Besides, the postoperative BCVA was significantly better in the inverted ILM flap group than in the ILM peeling group at 12 months after initial surgery (MD = −0.35; 95% CI: −0.52 to −0.18; P<0.0001). Conclusions. Thus, the MH closure rate and postoperative BCVA may be better with the inverted ILM flap technique than with ILM peeling for myopic MHRD, while the postoperative retinal reattachment rate appears to be similar with both techniques. Therefore, in the future, vitrectomy with the inverted ILM flap technique should be preferred over standard ILM peeling technique for the treatment of MHRD in highly myopic eyes.

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Treatment of Retinal Detachment Secondary to Macular Hole in Highly Myopic Eyes

Abstract: Combining pars plana vitrectomy with internal limiting membrane peel and silicone oil tamponade was safe and effective in treating MH-retinal detachment in highly myopic eyes. Silicone oil tamponade may improve initial anatomical success rates because of longer tamponade duration.

Cited by 23 publications

References 28 publications

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

Primary silicone oil tamponade and internal limiting membrane peeling for retinal detachment due to macular hole in highly myopic eyes with chorioretinal atrophy

Inverted Internal Limiting Membrane Flap Technique versus Internal Limiting Membrane Peeling for Vitrectomy in Highly Myopic Eyes with Macular Hole-Induced Retinal Detachment: An Updated Meta-Analysis

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