Surgical management of retinal detachment associated with myopic macular hole

Objective To evaluate the efficacy of macular reinforcement combined with internal limiting membrane removal and gas tamponade with perfluoropropane injection for macular hole related retinal detachment in patients with high myopia.Methods Ten eyes of 10 patients with retinal detachment associated with myopic macular hole received the surgery of macular reinforcement combined with pars plana vitrectomy,internal limiting membrane peeling and gas tamponade.All patients were with ocular axial length over 27.0 mm,macular retinal detachment,and full thickness macular hole.Patients with inflexible retina were excluded.Postoperative follow-up was 6 ～ 18 months.Results The retina reattached in the 10 eyes following the initial surgery.Retinal detachment recurred in one eye one month after the initial surgery,after perfluoropropane gas tamponade done again,the retina was reattached,but the macular hole did not be closed.The macular hole was anatomically closed in five eyes and partially closed in five eyes,still some tissue defect in the macular center.No iatrogenic retinal tear formed in the operation.Postoperative vitreous hemorrhage appeared in one eye after surgery and resolved spontaneously 2 weeks latter.No endophalmitis happened postoperatively.Conclusion Macular reinforcement combined with pars plana vitrectomy,internal limiting membrane peeling and gas tamponade with perfluoropropane is a safe and effective surgical treatment for macular hole related retinal detachment in patients with high myopia. Key words: Reinforcement, macular;  Removal, membrane,internal limiting;  Myopia,high;  Hole,macular