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Macular hole repair by vitrectomy and internal limiting membrane peeling in highly myopic eyes

Lan-Hsin Chuang1, Yen-Po Chen, Nan-Kai Wang

  • 1*Department of Ophthalmology, Chang-Gung Memorial Hospital, Keelung, Taiwan; †Chang Gung University College of Medicine, Taoyuan, Taiwan; and ‡Department of Ophthalmology, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.

Retina (Philadelphia, Pa.)
|May 27, 2014
PubMed
Abstract

Insights

Vitrectomy with internal limiting membrane peeling effectively repairs macular holes (MH) in highly myopic eyes, improving visual acuity. While successful, potential complications include delayed closure and retinal detachment.

Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • High Myopia Research

Background:

  • Macular holes (MH) in highly myopic eyes present unique surgical challenges.
  • Standard surgical approaches may have variable outcomes in this patient population.

Purpose of the Study:

  • To evaluate the surgical outcomes of macular hole (MH) repair using vitrectomy and internal limiting membrane peeling in eyes with high myopia.
  • To assess both anatomical and functional results of this surgical technique.

Main Methods:

  • A retrospective interventional case series included 30 highly myopic eyes from 29 patients undergoing vitrectomy and internal limiting membrane peeling for MH repair.
  • Optical coherence tomography assessed anatomical outcomes, while best-corrected visual acuity (BCVA) changes evaluated functional outcomes.
  • Mean follow-up was 36.4 months.

Main Results:

  • The final MH closure rate was 97% (29/30 eyes), with 87% achieving closure after a single surgery.
  • BCVA significantly improved from 1.20 to 0.77 logMAR (P = 0.003).
  • Complications included rhegmatogenous retinal detachment in 10% of eyes; myopic foveoschisis was noted in 10%.

Conclusions:

  • Vitrectomy with internal limiting membrane peeling is an effective surgical strategy for MH repair in highly myopic eyes, yielding positive anatomical and functional results.
  • Visual acuity may show slow improvement up to three years post-surgery.
  • Potential risks include delayed hole closure and rhegmatogenous retinal detachment, particularly in eyes with associated myopic foveoschisis.

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