Retinal detachment due to macular hole in highly myopic eyes. Pronostic factors

Purpose: To evaluate the pronostic value of axial length and epiretinal mem brane (ERM) separation during vitrectomy for retinal detachment due to macu lar hole in high myopia. Patients and methods: Thirty-two consecutive highly myopic eyes (31 patient s) with retinal detachment due to a macular hole were retrospectively studi ed. All eyes underwent pars plana vitrectomy with gas tamponade (C3F8). An epiretinal membrane was removed in 9 cases. The 32 cases were divided into 3 groups: anatomical success after the initial surgery (group 1, 15 cases); anatomical success after two surgical procedures without silicone oil (gro up 2. 5 cases), and silicone oil tamponade (group 3, 12 cases). Results: Retinal reattachment occurred in 15 cases (46.8%) after the initia l surgery. The difference of axial length between the 3 groups was not sign ificant. The rate of anatomical success without silicone oil was 88.8% (8/9 cases) when an ERM was peeled and the number of peelings was significantly higher (p=0,04) in group 1 than in group 3. Conclusion:The axial length was not a pronostic factor of silicone oil tamp onade in this study. The success rate was higher when an ERM was peeled. Ho wever, considering the technical difficulty in removing the ERM completely, gas tamponade seems to be the better initial treatment.