Outcomes of macular hole surgery in highly myopic eyes : a case‐control study

Abstract Purpose To evaluate the outcomes of macular hole (MH) surgery in highly myopic eyes and to compare these results with controls. Methods The study design was a matched, case‐control, retrospective chart review. Ninety‐four eyes who underwent vitrectomy with internal limiting membrane removal for a MH without retinal detachment were included. Group 1 included 47 consecutive eyes with high myopia and group 2 included 47 control eyes operated on the same period and matched for MH size. The main outcomes were preoperative and postoperative best‐corrected visual acuity (BCVA), MH closure rates and complications. Results The mean axial length was 28,5 mm in high myopic eyes and 23,3 mm in the controls (p<0,001). There was no significant difference in the mean duration of symptoms, size of the MH and preoperative BCVA between the two groups. Closure of the MH was achieved in only 39/47 eyes (83%) with high myopia versus to 45/47 eyes (96%) in the controls (p=0,04). Mean BCVA improved in both groups (0,41 versus 0,68 logMAR) but was significantly lower in myopic eyes (p<0,001). Anatomical outcomes tended to decrease when axial length increased (p=0,06). Conclusion MH surgery in high myopic eyes results in satisfactory anatomical and visual improvement but not as good as in the controls. Longer axial length may increase the risk of anatomic failure.