Assessment Of Myopic Macular Hole Surgery

During the period from 1/10/1998 to 1/11/2001, thirty-eighteyes of 38 patients with retinal detachment associated with myopicmacular hole were involved in this study that was carried out in thedepartment of ophthalmology, Zagazig University.The aim of this wok was to evaluate the different surgicaltechniques adopted for treatment of this type of retinal detachment.Preoperative evaluation of the patients aimed at detection of factorsthat may predict the anatomical and the visual outcome in thosepatients. These factors included the axial length, presence ofposterior staphyloma, chorioretinal degeneration, aphakia andproliferative vi treoretinopathy.Four surgical techniques were applied. These were pneumaticretinopexy, primary scleral buckling for cases associated withperipheral retinal breaks in addition to the macular hole, vitrectomyand fluid gas exchange and lastly, vitrectomy and silicone oilinjection.Out of eighteen eyes treated by pneumatic retinopexy, retinalreattachment was achieved in 9 eyes (50%). Eight of the recurrentcases had central chorioretinal atrophy with depigmentation of theretinal pigment epithelium while only 2 of the successful cases hadchorioretinal atrophy.Retinal reattachment was obtained in 5 out of 9 eyes (55.5%)treated primarily by encircling scleral buckle for the associatedperipheral tears.Retinal reattachment was achieved in 4 out of 5 eyes (80%)treated by vitrectomy and fluid gas exchange and in 15 out of 18(83%) eyes treated by vitrectomy and silicone oil injection.