Macular Buckling During Silicone Oil Removal in Pathologic Myopia with Macular Detachment or Persistent Macular Hole

To evaluate anatomic and functional outcomes of macular buckling (MB) performed during silicone oil removal in highly myopic eyes with persistent macular retinal detachment (RD), with or without macular hole (MH), after prior pars plana vitrectomy.

This retrospective consecutive case series included 62 highly myopic eyes with silicone oil tamponade and persistent or recurrent macular detachment after vitrectomy. Eyes were classified as having MH-related RD (MH-RD, n = 51) or tractional RD (TRD, n = 11). All eyes underwent MB with silicone oil removal. The primary outcomes were retinal reattachment at 1 year and successful silicone oil removal at final follow-up, defined as an oil-free status without reinjection. Secondary outcomes included best-corrected visual acuity (BCVA) and MH status at 1 year.

Retinal reattachment at 1 year was achieved in 59 of 62 eyes (95.2%), including 48 of 51 MH-RD eyes (94.1%) and all 11 TRD eyes (100%). Silicone oil was successfully removed in 50 eyes (80.6%). Among MH-RD eyes, 43 (84.3%) achieved type 2 MH closure, whereas 8 (15.7%) remained unclosed; no cases of type 1 closure were observed. Despite the absence of complete hole closure, durable retinal reattachment was maintained in the majority of MH-RD eyes. BCVA improved significantly in the MH-RD group (from 1.57 ± 0.50 to 1.31 ± 0.48 logarithm of the minimum angle of resolution, P = 0.005), but not in the TRD group (P = 0.139).

In highly myopic eyes with persistent macular detachment after vitrectomy, MB at the time of silicone oil removal provided effective structural support, achieved high retinal reattachment rates at 1 year, and allowed successful oil removal in most eyes.

The authors have no proprietary or commercial interest in any materials discussed in this article.