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Macular hole surgery in high myopia
S C Patel1, R H Loo, J T Thompson
1Department of Ophthalmology, Greater Baltimore Medical Center, Baltimore, Maryland. Retina Specialists, Baltimore, Maryland, USA.
Purpose:
To evaluate the anatomic and functional outcomes of macular hole surgery in high myopia and to determine whether surgery is beneficial in myopic eyes with macular holes.
Design:
Retrospective noncomparative case series.
Participants:
Twenty eyes of 18 highly myopic subjects who underwent pars plana vitrectomy for macular holes.
Methods:
We analyzed demographics, preoperative, and postoperative characteristics in 20 eyes with macular holes with a mean of 10.4 months duration and myopia of 6 diopters or greater.
Main Outcome Measures:
Macular hole closure rate and mean visual acuity preoperatively and postoperatively.
Results:
Mean subject age was 56.4 years and preoperative visual acuity was 20/100+2. The macular hole was closed with one surgery in 60.0% of eyes and in 85.0% of eyes with one or more surgeries. The mean final acuity in all eyes was 20/63, and 40.0% improved greater than three Snellen lines at the final visit. The use of adjunctive agents seemed to have no effect on macular hole closure or visual acuity. A subgroup of three myopic eyes with retinal detachments surrounding the macular hole had successful closure with visual acuity improvement in two of three eyes.
Conclusions:
Macular hole surgery can give substantial visual improvement in myopic eyes with macular holes, but the anatomic closure rates are lower than in eyes with idiopathic macular holes, and thus a higher reoperation rate is required.