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Double peel using triamcinolone acetonide and trypan blue in the management of myopic macular hole with retinal
Kenneth K W Li1, Emily W H Tang, Patrick S H Li
1Department of Ophthalmology, United Christian Hospital, and Eye Institute, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Kowloon, Hong Kong SAR, China. kennethli@rcsed.ac.uk
Purpose:
To evaluate the safety and efficacy of double peel using triamcinolone acetonide (TA) and trypan blue (TB) in removing epiretinal tissues in vitrectomy for myopic macular hole with retinal detachment (MHRD).
Methods:
Prospective interventional case control study. Patients with myopic MHRD underwent vitrectomy with TA-assisted adherent cortical vitreous (ACV) removal followed by TB-assisted internal-limiting membrane (ILM) peeling and gas tamponade. The results were compared with historical control group without the use of any vital dye or TA.
Results:
Ten eyes of 10 study cases were compared with nine eyes of nine control cases. Mean axial length was 28.3 ± 1.4 mm and 29.6 ± 2.4 mm and mean follow-up period was 15 months and 42 months for the study group and the control group, respectively. Reattachment rate was 70% in the study group and 44% in the control group. Mean logMAR visual acuity improvement was 0.02 at 6 months and 0.01 at 12 months for the study group (P < 0.05). Transient intraocular pressure rise was observed in seven eyes in the study group and five eyes in the control group. No other complication was noted.
Conclusion:
Double peel using TA and TB appeared safe and effective in facilitating removal of ACV and ILM in MHRD. It has higher surgical success rate compared with conventional vitrectomy with epiretinal membrane peeling and gas tamponade.