Effectiveness of combined macular buckle under direct vision and vitrectomy with ILM peeling in refractory macular hole retinal detachment with extreme high axial myopia: a 24-month comparative study

Purpose: To evaluate the risks that might be associated with recurrent macular hole retinal detachment (Re MHRD) after silicone oil (S.O) removal in myopic patients with open flat macular hole (MH). Methods: In this retrospective series, we assessed the different factors that might be associated with recurrent MHRD after S.O removal in 48 eyes with open flat MH that underwent S.O removal after successful MHRD repair by dividing the enrolled eyes into 2 groups: group 1 included 38 eyes with flat open MH and flat retina after S.O removal and group 2 included 10 eyes with flat open MH and recurrent MHRD after S.O removal. Results: Ten of 48 eyes (20.8%) with open flat MH developed recurrent MHRD after S.O removal. Univariate logistic regression analysis revealed that MH at the apex of PS, MH minimum diameter, hole form factor (HFF) and MH index (MHI) were significant risk factors for recurrent MHRD after S.O removal in myopic patients with open flat MH. Conclusions: If there is a "flat open" MH that is large, located at the apex of PS or with HHF or MHI of less than 0.9-0.5, it has a high chance of recurrent MHRD after S.O removal.

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A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

Journal of Ophthalmology ◽

10.1155/2017/6742164 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Ahmed M. Bedda ◽

Ahmed M. Abdel Hadi ◽

Mohamed Lolah ◽

Muhammad S. Abd Al Shafy

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Hole ◽

High Myopia ◽

Terminal Part ◽

Macular Hole Retinal Detachment ◽

Myopic Macular Hole ◽

The Mean ◽

Visual Results

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p<0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p=0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

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Recurrence of Macular Hole Retinal Detachment after Intravitreal Ranibizumab Injection for the Treatment of Choroidal Neovascularization from the Remaining Macular Hole Edge

Case Reports in Ophthalmology ◽

10.1159/000346041 ◽

2012 ◽

Vol 3 (3) ◽

pp. 424-427 ◽

Cited By ~ 6

Author(s):

Keiko Otsuka ◽

Hisanori Imai ◽

Tsuyoshi Shimoyama ◽

Takayuki Nagai ◽

Shigeru Honda ◽

...

Keyword(s):

Retinal Detachment ◽

Macular Hole ◽

Choroidal Neovascularization ◽

Intravitreal Ranibizumab ◽

Hole Edge ◽

Macular Hole Retinal Detachment

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Foveal microstructure and visual outcomes of myopic macular hole surgery with or without the inverted internal limiting membrane flap technique

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313311 ◽

2018 ◽

Vol 103 (10) ◽

pp. 1495-1502 ◽

Cited By ~ 4

Author(s):

Xu-Ting Hu ◽

Qin-Tuo Pan ◽

Jing-Wei Zheng ◽

Zong-Duan Zhang

Keyword(s):

Retinal Detachment ◽

Macular Hole ◽

Internal Limiting Membrane ◽

Ilm Peeling ◽

Closure Rate ◽

Flap Technique ◽

Hyperreflective Foci ◽

Retinal Reattachment ◽

Pars Plana ◽

Myopic Macular Hole

PurposeThe aim of this study was to determine the effect of the inverted internal limiting membrane (ILM) flap technique on the macular hole (MH) closure and foveal microstructure recovery of patients with highly myopic MH.MethodsPars plana vitrectomy and gas tamponade with the inverted ILM flap technique (19 eyes) or with the ILM peeling technique (21 eyes) were performed in patients with highly myopic MH with or without retinal detachment. The rate of MH closure and retinal reattachment, the reconstructive anatomical change of the foveal microstructure and the best-corrected visual acuities (BCVA) of the two groups were compared.ResultsThe anatomic closure rate was statistically significantly higher in the inverted group (100%) than in the peeling group (66.7%; p=0.009). All eyes with MH retinal detachment had successful retinal reattachment in these two groups. However, the rate of the external limiting membrane (ELM) and ellipsoid zone (EZ) (p=0.020), as well as gliosis (p=0.049) in macular area, detected by OCT, was significantly greater in the inverted group than in the peeling group. The postoperative BCVA was significantly better in the eyes with ELM, EZ (p=0.031) and gliosis (p=0.008), but without hyperreflective foci (p=0.001).ConclusionsThese findings demonstrate that the inverted ILM flap technique has better efficacy than the ILM peeling technique for patients with myopic MH in closure rate, foveal microstructure and postoperative BCVA.

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