Efficacy of different surgeries in the treatment of high myopia patients with moderately long axial length and macular hole retinal detachment
10.3980/j.issn.1672-5123.2025.8.21
- VernacularTitle:不同手术方式治疗中度长眼轴高度近视黄斑裂孔性视网膜脱离
- Author:
Bohan XU
1
,
2
,
3
;
Xiaoying WEN
1
,
2
,
3
;
Zhaohui GU
1
,
2
,
3
Author Information
1. Graduate School of Chengde Medical University, Chengde 067000, Hebei Province, China
2. Baoding No.1 Central Hospital
3. Key Laboratory of Macular Disease Prevention and Control in Baoding, Baoding 071000, Hebei Province, China
- Publication Type:Journal Article
- Keywords:
high myopia;
macular hole retinal detachment;
pars plana vitrectomy;
internal limiting membrane tamponade;
autologous blood coverage
- From:
International Eye Science
2025;25(8):1330-1335
- CountryChina
- Language:Chinese
-
Abstract:
AIM: To compare the efficacy of simple autologous blood coverage with ILM flap tamponade combined with autologous blood coverage after pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling in treating macular hole retinal detachment(MHRD)of high myopia patients with moderately long axial length.METHODS: This retrospective study enrolled 45 patients(45 eyes)with high myopia and MHRD, and axial lengths of 26-29 mm treated at our institution between January 1, 2020 and January 1, 2024. Patients were divided into two groups based on surgical technique: group A(24 eyes)underwent PPV with ILM peeling, ILM flap tamponade, autologous blood coverage, and silicone oil injection; group B(21 eyes)received PPV with ILM peeling followed by autologous blood coverage and silicone oil injection. Intraocular pressure, best-corrected visual acuity(BCVA), retinal reattachment and macular hole closure status were compared at 1 wk, 1, 3, and 6 mo postoperatively. Silicone oil removal was performed at 6 mo postoperatively, with additional 2-month follow-up.RESULTS:At 8-month postoperative follow-up, both groups achieved complete retinal reattachment. Macular hole closure rates showed no significant intergroup difference(88% vs 86%, P=0.860). Significant improvement in BCVA was observed in both groups compared to preoperative values, with the group B demonstrating better visual outcomes than the group A(P<0.001). Transient parafoveal subretinal fluid persistence was noted in 2 eyes of the group A(resolved spontaneously at 5 and 8 mo post-PPV, respectively), and 1 eye of the group B(resolved by 4 mo post-PPV). Serial optical coherence tomography(OCT)monitoring revealed no macular hole reopening, with complete subretinal fluid resolution confirmed in all cases at final follow-up.CONCLUSION:For high myopic MHRD patients with moderately long axial length, both surgical approaches effectively promote macular hole closure and retinal reattachment. However, the autologous blood coverage technique demonstrates better BCVA than the combined ILM tamponade.
