Primary Silicone Oil Tamponade with Vitrectomy in Macular Hole Retinal Detachment of Highly Myopic Eyes

In Tae Kim; Young Jung Roh

doi:10.3341/jkos.2008.49.8.1263

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Kim and Roh: Primary Silicone Oil Tamponade with Vitrectomy in Macular Hole Retinal Detachment of Highly Myopic Eyes

Original Article

J Korean Ophthalmol Soc 2008;49(8):1263-1268.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1263

Primary Silicone Oil Tamponade with Vitrectomy in Macular Hole Retinal Detachment of Highly Myopic Eyes

In Tae Kim, M.D., Young Jung Roh, M.D.

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Young Jung Roh, M.D. Department of Ophthalmology, St. Mary's Hospital, The Catholic University of Korea #62 Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea Tel: 82-2-3779-1848, Fax: 82-2-761-6869, E-mail: youngjungroh@hanmail.net

Received 4 August 2008 Accepted 28 December 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To determine the results of pars plana vitrectomy and silicone oil tamponade to treat retinal detachment caused by macular holes in highly myopic eyes.

Mthods

Eighteen highly myopic patients with spontaneous retinal detachment due to macular holes underwent vitrectomy and primary silicone oil tamponade. Preoperative statuses and postoperative results were reviewed. All patients had high myopia with axial lengths longer than 28 mm or had definite staphyloma. The average follow‐ up period was 24 months.

Results

Successful retinal attachment of the retina was achieved in 17 eyes, though 1 eye had redetached. Of the 17 eyes, 13 eyes achieved anatomical macular hole closure and 7 eyes showed improved visual acuity.

Conclusions

Vitrectomy and silicone oil tamponade for retinal detachment due to macular holes in highly myopic eyes produce good anatomical and functional results.

Keywords: High myopia, Macular hole retinal detachment, Silicone oil tamponade, Vitrectomy

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Figure 1.

(A) Fundus examation reveals a macular hole with surrounding retinal detachment at the posterior pole in the left eye. (B) B-scan demonstrates a posterior staphyloma and retinal detachment restricted to the posterior pole. (C) OCT scan shows a macular hole and retinal detachment. It also shows a posterior vitreous detachment (PVD) and absence of retinal reflectivity in the central macular area and large subretinal fluid.

Figure 2.

(A) Fundus examination shows a sealed macular hole and attached retinal detachment. (B) B-scan shows no retinal detachment at the posterior pole. (C) OCT scan demontrates reapproximation of the edge of the macular hole and intimate attachment of the neurosensory retina.

Table 1.

Baseline characteristics of patients

No.	Sex	Age	Axial length (mm)	Staphyloma	Lens	PVD	FD (mo)	Follow-up (mo)	Preop.	VA Postop.	Change	Complication
1	F	62	28.11	Yes	Phakic	Complete	14	47	0.02	0.02	↔	None
2	M	50	29.06	No	Pseudophakic	Complete	36	36	CF+	0.02	↑	Raised IOP
3	F	67	27.63	Yes	Phakic	Complete	4	31	0.02	0.1	↑	None
4	F	63	27.04	Yes	Phakic	Incomplete	2.5	27	0.1	0.1	↔	None
5	F	58	22.38	Yes	Phakic	Incomplete	15	25	CF+	0.04	↑	None
6	F	71	30.83	Yes	Pseudophakic	Complete	25	25	0.1	0.1	↔	Raised IOP
7	F	69	29.43	Yes	Phakic	Complete	4	13	0.02	CF+	↓	None
8	F	84	26.77	Yes	Pseudophakic	Complete	3	22	0.02	0.02	↔	Raised IOP
9	M	67	26.29	Yes	Phakic	Complete	3	21	0.1	0.06	↓	None
10	F	78	31.79	Yes	Phakic	Complete	4	21	CF+	CF+	↔	None
11	F	39	26.79	Yes	Phakic	Complete	18	18	CF+	0.04	↑	None
12	F	60	27.68	Yes	Phakic	Complete	3	12	CF+	CF+	↔	None
13	M	75	28.43	No	Pseudophakic	Complete	2	13	0.1	0.1	↔	None
14	M	13	27.85	Yes	Phakic	Incomplete	4	21	0.02	HM+	↓	Redetachment
15	F	61	26.76	Yes	Pseudophakic	Incomplete	11	53	CF+	0.1	↑	None
16	F	53	27.74	Yes	Phakic	Complete	3	12	CF+	0.08	↑	Raised IOP
17	F	65	29.07	Yes	Phakic	Complete	4	17	HM+	CF+	↑	None
18	F	55	30.23	Yes	Phakic	Complete	4	16	CF+	CF+	↔	None

PVD=posterior vitreous detachment; FD=filling duration of silicone oil; Preop=preoperative visual acuity; Postop=final visual acuity; IOP=intraocular pressure.

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