Korean J Ophthalmol.  2004 Dec;18(2):141-147. 10.3341/kjo.2004.18.2.141.

Effect of Internal Limiting Membrane Removal in Treatment of Retinal Detachment Caused by Myopic Macular Hole

• Cho H
• Choi A
• Kang SW

• KMID: 754379
• DOI: http://doi.org/10.3341/kjo.2004.18.2.141

Abstract

The purpose of this study was to evaluate the anatomical outcomes of vitrectomy with internal limiting membrane removal in highly myopic eyes with retinal detachment caused by a macular hole. Nineteen, consecutive, highly myopic eyes with full thickness macular hole with retinal detachment were treated by vitrectomy with internal limiting membrane removal, endolaser photocoagulation on the center of the hole and fluid gas exchange. In five eyes with other peripheral breaks, scleral buckling (3 cases), encircling (1 case) and barrier laser (1 case) were combined. In 15 eyes (79.0%) the macular hole was closed after the initial surgery. In 4 eyes (21%) the macular hole was reopened, but these were successfully treated with fluid gas exchange (1 case) or macular buckling (3 cases). The visual acuity was improved in 15 eyes (79.0%). In conclusion, these results suggest that the removal of the perifoveal internal limiting membrane may be an important adjuvant in the treatment of the myopic macular hole with retinal detachment.

Keyword

high myopia; internal limiting membrane; macular hole; retinal detachment

MeSH Terms

Adult
Aged
Aged, 80 and over
Basement Membrane/surgery
Comparative Study
Female
Fundus Oculi
Humans
Male
Middle Aged
Myopia, Degenerative/*complications
Retinal Detachment/etiology/*surgery
Retinal Perforations/*complications
Retrospective Studies
Tomography, Optical Coherence
Treatment Outcome
Visual Acuity
Vitrectomy/*methods

Figure

• 

  Fig. 1 Pre-operative (A,B) and post-operative (C,D) optical coherence tomographic(OCT) and fundus photography findings (case 10). Retinal detachment caused by macular hole was developed (A,B). Spherical equivalent was -5.875 diopters and there was no other break. After vitrectomy, internal limiting membrane peeling and fluid-gas exchange, the retina was reattached (C). OCT image confirms the reattachment of the retina and closure of the macular hole (D).

• 

  Fig. 2 Internal limiting membrane removed from the retina surrounding the macular hole. Notice the cells, which shows fibrous astrocytes (asterisk) attached to the inner surface of the internal limiting membrane (arrow). (TEM, bar 8µm) (×1000)

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