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Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three-year results.

Authors :
Wu AL
Ling KP
Chuang LH
Chen KJ
Chen YP
Yeung L
Wang NK
Liu L
Chen TL
Hwang YS
Wu WC
Lai CC
Source :
Acta ophthalmologica [Acta Ophthalmol] 2020 Nov; Vol. 98 (7), pp. e839-e847. Date of Electronic Publication: 2020 Apr 03.
Publication Year :
2020

Abstract

Purpose: To investigate the long-term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes.<br />Methods: Thirty-five cases of highly myopic eyes with MHRD in 35 patients who underwent an initially successful vitrectomy with macular plug and were followed up for at least 3 years were reviewed. The anatomical outcomes were evaluated by fundus examination, fundus photographs and optical coherence tomography (OCT). Myopic features after the surgery were differentiated according to recommendations of the Meta-analysis of Pathologic Myopia (META-PM) Study Group. The best-corrected visual acuities (BCVAs) before and after surgery were analysed as the functional outcome. Main outcome measures time-course changes in BCVA and complications.<br />Results: The mean patient age was 61.0 ± 11.4 years. The follow-up was 45.2 ± 8.6 months (ranged from 36 to 71 months). The mean axial length was 29.3 ± 1.2 mm. All eyes demonstrated attached retina, but 2 eyes (5.7%) developed reopened macular holes until the last follow-up. Complications of postoperative rhegmatogenous retinal detachment were detected in 2 eyes (5.7%) within 1 year and retina reattached after the secondary vitrectomy. Three cases (8.6%) of prolonged subretinal fluid lasting more than 1 year were detected but finally absorbed completely. Comparing 1-3 years postoperatively, myopic features showed significant progression of myopic maculopathy category (p = 0.035). Functionally, significantly improved BCVA could be maintained postoperatively between 6 months and 3 years. However, vision of 14 eyes (40.0%) worsened within 1-3 years postoperatively, and visual deterioration was associated with progression of myopic maculopathy (p = 0.004) and pre-existing disease of glaucoma (p = 0.006).<br />Conclusions: A vitrectomy combined with macular plug provided favourable outcomes in the long term, over the ≥3-year follow-up period.<br /> (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1755-3768
Volume :
98
Issue :
7
Database :
MEDLINE
Journal :
Acta ophthalmologica
Publication Type :
Academic Journal
Accession number :
32243725
Full Text :
https://doi.org/10.1111/aos.14418