[New approach for management of retinal detachment with macular hole]

Three kinds of unconventional methods were used to treat retinal detachment with macular hole in 17 cases (17 eyes). A combination of vitrectomy, transscleral drainage and intraocular air injection was used for the cases of retinal detachment with macular hole and evident vitreous traction. Transscleral drainage combined with air injection was used for those of macular hole without vitreous traction. For the cases of combined peripheral and macular holes, we treated only peripheral holes, ignoring the macular hole. After a 3-16 months follow-up, 15 out of the 17 eyes obtained retinal anatomic reattachment (88.2%), 10 eyes had their vision improved, 4 eyes remained unchanged, 9 eyes obtained a visual acuity of better than 0.05 postoperatively. Compared with the conventional method of macular buckling, these procedures have the advantages of less damage to macula, less complications and more satisfactory visual improvement.