Pars plana vitrectomy combined with inverted internal limiting membrane flap technique for the treatment of macular hole retinal detachment in high myopia

Abstract

AIM: To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)peeling or inverted ILM flap for the treatment of macular hole retinal detachment(MHRD)in high myopia.METHODS: A retrospective clinical study. A total of 38 cases(38 eyes)with MHRD in high myopia were treated with PPV combined with ILM peeling or PPV combined with inverted ILM flap in our hospital from January 2020 to June 2021. They were divided into control group(PPV combined with ILM peeling)and observation group(PPV combined with inverted ILM flap)according to the surgical method. Follow-up to 3mo after surgery, the surgery time, best corrected visual acuity(BCVA), the rate of macular hole closure and retinal reattachment were compared between two groups.RESULTS: The surgery time of two groups were compared and there were no statistically significant difference(30.71±4.55min vs. 35.20±5.44min, P=0.384). The BCVA in the two groups were significantly improved at the last follow-up(all P<0.01). But there was no difference in the postoperative BCVA(LogMAR)of the two groups(1.39±0.24 vs. 1.46±0.27, P=0.700). The rate of macular hole closure in the observation group was higher than that of control group(100% vs. 71%, P=0.024). There was no difference in the rate of recurrent retinal detachment of the patients in two groups(0 vs. 10%, P=0.492).CONCLUSION: Both surgeries can improve the BCVA, while PPV combined with inverted ILM flap has higher rate of macular hole closure.

Keywords

• high myopia
• macular hole retinal detachment
• pars plana vitrectomy
• inverted internal limiting membrane flap
• internal limiting membrane peeling