EVALUATION OF THE EFFICACY OF POSTERIOR SCLERAL CONTRACTION IN THE TREATMENT OF MACULAR HOLE WITH RETINAL DETACHMENT IN HIGH MYOPIA

• Published in: Retina (Philadelphia, Pa.) Vol. 41; no. 9; p. 1874
• Main Authors: Ye, Jie, Wu, Yue, Zhu, Shuangqian, Dong, Liang, Qu, Jia, Lu, Fan, Xue, Anquan
• Format: Journal Article
• Language: English
• Published: United States 01.09.2021
• Subjects: Female; Follow-Up Studies; Humans; Male; Middle Aged; Myopia, Degenerative - complications; Myopia, Degenerative - physiopathology; Myopia, Degenerative - surgery; Retina - diagnostic imaging; Retinal Detachment - diagnosis; Retinal Detachment - etiology; Retinal Detachment - surgery; Retinal Perforations - diagnosis; Retinal Perforations - etiology; Retinal Perforations - surgery; Retrospective Studies; Sclera - diagnostic imaging; Sclera - surgery; Scleral Buckling - methods; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity
• ISSN: 1539-2864
• DOI: 10.1097/IAE.0000000000003126

To evaluate efficacy of posterior scleral contraction for macular hole with retinal detachment in high myopia. Seventy-three macular hole with retinal detachment eyes were treated with posterior scleral contraction. A strip was sent across inferior-temporal scleral surface to posterior pole, then two ends were led out from nasal-inferior to temporal-superior areas. It was tightened to contract posterior sclera with designed axial length shortening ([10% of preoperative axial length-0.5] mm) after aqueous humor was drained from anterior chamber. Recovery was classified as type I (retinal reattachment with MH bridged) and II (retinal reattachment without MH bridged). Follow-up duration was 25.3 ± 18.0 months. Axial length was 30.01 ± 2.27 mm at preoperation and shortened by 2.57 ± 0.82 mm intraoperatively. At final postoperation, maintained axial length shortening was 1.87 ± 0.92 mm. Forty-six eyes (63.0%) recovered as type I, 26 eyes (35.6%) as type II, and 1 eye (1.4%) unrecovered. Postoperative best-corrected visual acuity (logarithm of minimal angle of resolution) was better than preoperative one (0.85 ± 0.50 [Snellen 20/125] vs. 1.11 ± 0.56 [Snellen 20/250], P < 0.001) with correlation (r = 0.662, P < 0.001) and consistency (Kappa = 0.34, P < 0.001) between two. Best-corrected visual acuity improvement did not differ between recovery types (P = 0.206). Macular hole with retinal detachment was successfully recovered by posterior scleral contraction with axial length shortening. Visual improvement was achieved, correlated, and consistent with preoperative best-corrected visual acuity while independent of recovery types.