Vitrectomy outcomes in eyes with high myopic macular hole without retinal detachment

The purpose of this study is to evaluate the vitrectomy outcomes for high myopic patients with macular hole (MH) without retinal detachment and to compare these outcomes with those of control patients with idiopathic MH undergoing similar surgeries by the same surgeon.

The study was designed as a matched, case-control, retrospective chart review. We performed a retrospective chart review of consecutive cases that underwent vitrectomy for MH without retinal detachment from 2000 through 2008. Twenty-four eyes of 24 patients were selected to participate in this study. They were divided into 2 groups: 12 study eyes with high myopic MH without retinal detachment and 12 control eyes with idiopathic MH. The main outcomes were preoperative, postoperative best-corrected visual acuity (BCVA), MH closure rates, and complications in both groups.

There was a closure rate of 100% in both the study and control groups, and no cases of reopening were reported during the follow-up visits. After surgery, the mean BCVA of the study group remained stable. There was no significant improvement of mean BCVA after surgery (P = 0.35) in the study group. The mean BCVA of the control group improved significantly (P = 0.00) after surgery. The mean postoperative BCVA in the study group was significantly lower than that in the control group in a comparison using the Student's t-test (P = 0.01). In the study group, the BCVA improved or remained stable after surgery in 8 eyes (67%). In the control group, the BCVA of all eyes improved or remained stable. The proportion of eyes with BCVA improvement after surgery was significantly higher in the study group than in the control group (P = 0.03). Disappearance of the outer nuclear layer and photoreceptor layer in the foveola and thinning of the foveola was showed in the postoperative optical coherence tomography images of four eyes in the study group while in none of the eyes in the control group.

In summary, vitrectomy results in satisfactory anatomical improvement in patients with high myopic MH without retinal detachment. However, the visual acuity outcomes of the high myopic MH patients without retinal detachment were poorer than those for patients with idiopathic MHs.