Internal Limiting Membrane Flap Filling with Subretinal Fluid Preservation in Treatment of High Myopia Combined with Macular Hole Retinal Detachment
Objective To investigate the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)flap filling preserving subretinal fluid(SRF)in treatment of macular hole retinal detachment(MHRD)in patients with high myopia.Methods A retrospective case study was conducted.Thirty patients with high myopia MHRD(total of 32 eyes)with posterior staphyloma and chorioretinal atrophy from department of ophthalmology,Union Hospital,Tongji Medical Col-lege,Huazhong University of Science and Technology between August 2020 and June 2023 were included in the study.The mean axial length was(30.32±1.71)mm.All patients underwent PPV,SRF preservation,and macular hole(MH)nasal flap creation(utilizing the optic disc as a support to fix the detached retina).The ILM flap was inverted to fill MH,and the surgery ended with silicone oil tamponade.The patients were observed for SRF absorption,retinal reattachment,MH closure,and visual acuity changes in the follow-up.Results OCT examination within 1 week after the operation showed that 25 eyes had MH closure and SRF absorption,6 eyes had MH closure with residual SRF,and 1 eye had MH non-closure.During the follow-up period,residual SRF in 7 eyes was fully absorbed within 1 year(5 cases),18 months(1 case),and 21 months(1 case)after the operation.All 32 eyes had retinal reattachment after a single silicone oil removal,and the retinal reattachment rate was 100％.Among the 32 eyes,90.62％(29/32)had MH type Ⅰ closure,including 22 eyes with U-shaped closure,5 eyes with V-shaped closure,and 2 eyes with W-shaped transformation into U-shaped scar closure;9.38％(3/32)had MH type Ⅱ(W-shaped)closure.There was an im-provement in the postoperative best-corrected visual acuity(BCVA,logMAR)from(1.90±0.34)to(1.14±0.37),with a statis-tically significant difference(t=11.11,P＜0.01).Conclusion In the presence of residual SRF,the ILM flap inversion filling technique achieves MH closure successfully.The combination of PPV,SRF preservation,ILM flap filling,and silicone oil tam-ponade provides a preferred treatment for highly myopic MHRD with long eye axis and posterior staphyloma.
high myopiamacular hole retinal detachmentinternal limiting membranesubretinal fluidvitrectomy
万方数据
维普
