Efficacy of primary silicone oil tamponade for the treatment of retinal detachment caused by macular hole in high myopia

Am J Ophthalmol. 2011 Jan;151(1):148-55. doi: 10.1016/j.ajo.2010.07.023. Epub 2010 Dec 4.

Abstract

Purpose: To determine the effect of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and primary silicone oil tamponade without any postoperative position restrictions for retinal detachment (RD) caused by macular hole in high myopia.

Design: Retrospective, interventional case series.

Methods: Twenty-four eyes of 24 patients with RD caused by macular hole in high myopia (axial length more than 27.0 mm) were treated by PPV with ILM peeling and primary silicone oil tamponade. No position restrictions were issued to patients postoperatively.

Results: The retina reattached in 22 eyes (92%) following the initial surgery. The final retinal reattachment rate was 100% after a second surgery of macular buckling for the 2 eyes with initial failure. For eyes with initial successful reattachment, the mean best-corrected visual acuity (BCVA) was significantly improved from 1.8 ± 0.5 logMAR units before surgery to 1.2 ± 0.4 (P < .001, paired t test). No clinical factors were significantly associated with improvement of BCVA or macular hole closure using multivariate analysis.

Conclusions: For the treatment of RD caused by macular hole, PPV with ILM peeling and primary silicone oil tamponade showed a high retinal reattachment rate without any postoperative position restrictions. It also improved postoperative BCVA significantly. This may be a preferable method for the treatment of RD caused by macular hole in high myopia.

MeSH terms

  • Aged
  • Coloring Agents
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications
  • Myopia, Degenerative / physiopathology
  • Myopia, Degenerative / therapy*
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retinal Detachment / therapy*
  • Retinal Perforations / complications
  • Retinal Perforations / physiopathology
  • Retinal Perforations / therapy*
  • Retrospective Studies
  • Scleral Buckling
  • Silicone Oils / administration & dosage*
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*

Substances

  • Coloring Agents
  • Silicone Oils
  • Indocyanine Green