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Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three‐year results
Author(s) -
Wu AnLun,
Ling KietPhang,
Chuang LanHsin,
Chen KuanJen,
Chen YenPo,
Yeung Ling,
Wang NanKai,
Liu Laura,
Chen TunLu,
Hwang YihShiou,
Wu WeiChi,
Lai ChiChun
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14418
Subject(s) - vitrectomy , medicine , retinal detachment , macular hole , ophthalmology , fundus (uterus) , maculopathy , retinal , retina , visual acuity , surgery , optometry , retinopathy , optics , diabetes mellitus , physics , endocrinology
Purpose To investigate the long‐term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes. Methods Thirty‐five cases of highly myopic eyes with MHRD in 35 patients who underwent an initially successful vitrectomy with macular plug and were followed up for at least 3 years were reviewed. The anatomical outcomes were evaluated by fundus examination, fundus photographs and optical coherence tomography (OCT). Myopic features after the surgery were differentiated according to recommendations of the Meta‐analysis of Pathologic Myopia (META‐PM) Study Group. The best‐corrected visual acuities (BCVAs) before and after surgery were analysed as the functional outcome. Main outcome measures time–course changes in BCVA and complications. Results The mean patient age was 61.0 ± 11.4 years. The follow‐up was 45.2 ± 8.6 months (ranged from 36 to 71 months). The mean axial length was 29.3 ± 1.2 mm. All eyes demonstrated attached retina, but 2 eyes (5.7%) developed reopened macular holes until the last follow‐up. Complications of postoperative rhegmatogenous retinal detachment were detected in 2 eyes (5.7%) within 1 year and retina reattached after the secondary vitrectomy. Three cases (8.6%) of prolonged subretinal fluid lasting more than 1 year were detected but finally absorbed completely. Comparing 1–3 years postoperatively, myopic features showed significant progression of myopic maculopathy category (p = 0.035). Functionally, significantly improved BCVA could be maintained postoperatively between 6 months and 3 years. However, vision of 14 eyes (40.0%) worsened within 1–3 years postoperatively, and visual deterioration was associated with progression of myopic maculopathy (p = 0.004) and pre‐existing disease of glaucoma (p = 0.006). Conclusions A vitrectomy combined with macular plug provided favourable outcomes in the long term, over the ≥3‐year follow‐up period.