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AIM: To compare the outcome of C3F8 versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C3F8(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C3F8 and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.RESULTS: The macular hole closure rate was 77% in the C3F8 group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C3F8 group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg2 for the C3F8 group and 98.08±24.36 nV/deg2 for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg2 for the C3F8 group and 67.73±15.33 nV/deg2 for the silicone oil group, all of which were significantly higher compared to pre-operation [the response density of the first ring of P1 wave: 58.13±13.96 nV/deg2 for the C3F8 group and 55.30±10.48 nV/deg2 for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg2 for the C3F8 group and 47.43±11.97 nV/deg2 for the silicone oil group](all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C3F8 group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSION: Silicone oil tamponade or C3F8 tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C3F8 tamponade was superior to silicone oil in visual function recovery.
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AIM: To investigate the clinical efficacy of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane flap technique in the treatment of macular hole retinal detachment(MHRD)in high myopia.METHODS: A retrospective clinical study was conducted. A total of 63 patients(64 eyes)with high myopia and MHRD who treated at our hospital from October 2017 to October 2021 were selected as research subjects. They were divided into two groups according to different surgery, with 34 cases(35 eyes)who received PPV combined with inverted internal limiting membrane flap technique in group A, and 29 cases(29 eyes)received PPV combined with internal limiting membrane peeling in group B. The patients were followed up for 6mo. The two groups were compared in terms of the hole closure rate, the reduction rate of retinal detachment and best corrected visual acuity(BCVA)before operation and at 1wk, 1, 3 and 6mo after operation, and the postoperative complications were recorded.RESULTS: The hole closure rate within 6mo after operation was significantly higher in group A than in group B(P&#x003C;0.05), but there was no statistically significant difference in the reduction rate of retinal detachment(P&#x003E;0.05). The BCVA of the two groups was significantly improved over time after operation(P&#x003C;0.05). There was no statistically significant difference in BCVA between the two groups before operation and at 1wk, 1, 3 and 6mo after operation(P&#x003E;0.05). Complications were observed in the two groups, but there was no statistically significant difference in the incidence of complications between the two groups(P&#x003C;0.05).CONCLUSION: PPV combined with inverted internal limiting membrane flap technique is safe and effective in the treatment of MHRD in high myopia, which can effectively improve the patients' BCVA and the hole closure rate without influence on intraocular pressure.
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@#AIM: To evaluate the anatomical and visual recovery effects of vitrectomy(PPV)combined with inner limiting membrane(ILM)reversal tamponade or ILM stripping in the treatment of high myopia macular hole retinal detachment(MHRD).<p>METHODS:The literature was retrieved from China Knowledge Network(CNKI), VIP, Wanfang Database, PubMed, EMbase, Cochrane Library, European PMC, and Natural database. The search time was built until September 2018. The 6-month follow-up time was used to observe the macular hole closure, primary retinal detachment and BCVA. Meta-analysis was performed using Review 5.3 and Stata 15.1 software.<p>RESULTS: In this study, a comparative analysis of 266 eyes in 8 studies was included. Statistically, the effect of ILM reversal tamponade in the macular hole closure rate is better than ILM stripping, the difference was statistically significant(<i>RR</i>=2.05, 95% <i>CI</i> 1.69 to 2.49, <i>P</i><0.00001), there was no statistically significant difference in the efficacy of primary retinal detachment rate(<i>RR</i>=1.04, 95% <i>CI</i> 0.98 to 1.12, <i>P</i>=0.21), the BCVA of the two groups was significantly higher than that before surgery at 6mo after surgery, the difference was statistically significant(<i>RR</i>=0.44, 95% <i>CI</i> 0.33 to 0.55, <i>P</i><0.00001; <i>RR</i>=0.29, 95% <i>CI</i> 0.10 to 0.48, <i>P</i>=0.003). The results of the extent of BCVA improvement between the two groups are heterogeneous, and the conclusions may be unstable, and more reliable data are needed.<p>CONCLUSION: PPV+ ILM flap insertion is more effective in treating patients with high myopia macular hole retinal detachment.
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@#Macular hole retinal detachment(MHRD)mainly occurs in high myopic eyes with posterior scleral staphyloma and always causes severe visual impairment. The pathogenesis of MHRD in high myopic eyes is still unclear. It is generally believed that it involves various complex traction. A variety of surgical methods have been tried to remove retina tractionin order to achieve retina reattachment and macular hole closure. This article reviews the current surgical methods and progress of MHRD in high myopic eyes.
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@#AIM: To compare the effect of pars plana vitrectomy(PPV)combined with internal limiting membrane peeling(ILMP)for macular hole retinal detachment(MHRD).<p>METHODS: Totally 78 patients with MHRD from December 2013 to December 2015 in our hospital were randomly divided into control group(39 patients 43 eyes)and experimental group(39 patients 40 eyes). The control group was treated with PPV, experimental group with PPV combined with ILMP. We observed the therapeutic effect and recorded the occurrence of postoperative complications. After 6mo follow-up, the vision improvement of the two groups were compared as the average of the best corrected visual acuity(BCVA)before and at 3, 6mo after surgery. <p>RESULTS: The reattachment rate of experimental group was 92%(37/40)with significant difference compared with control group(<i>χ</i><sup>2</sup>=6.882, <i>P</i>=0.009). The improvement of visual acuity in the experimental group was better than that in the control group(<i>χ</i><sup>2</sup>=14.216, <i>P</i><0.001). The postoperative BCVA of the experimental group at 3 and 6mo was significantly higher than that of the control group(<i>t</i>=7.119, <i>P</i><0.001; <i>t</i>=10.573, <i>P</i><0.001). There were less patients with the situation of increased intraocular pressure and visual field defect(<i>χ</i><sup>2</sup>=11.323, <i>P</i>=0.001; <i>χ</i><sup>2</sup>=8.573, <i>P</i>=0.003). The lens opacity occurrence rate had not significantly changed(<i>χ</i><sup>2</sup>=1.835, <i>P</i>=0.176).<p>CONCLUSION: MHRD patients treated with PPV combined with ILMP recovered better and the incidence of complications was lower. It can improve the patient's retinal restoration effect more.
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Background Macular hole retinal detachment(MHRD) causes severe decrease of vision.Pars plana vitrectomy has been applied for MHRD.Silicone oil and C3F8 have been used as intraocular tamponade materials,while there are still controversity on their efficacy.Objective This trial was to evaluate the efficacy of vitreous surgery combined with silicone oil or C3F8 tamponade for patients with MHRD in highly myopic eyes.Methods A retrospective case-controlled study was designed.Fifty-one patients who underwent vitrectomy with intraocular tamponade were retrospectively analyzed.The best corrected visual acuity(BCVA) before and after surgery were examined and campared between two groups.The rate of recurrent RD and macular hole closed were analyzed.Results There was no significant difference in BCVA between silicone oil group and C3F8 tamponade group before and after surgery(U=266.000,P =0.286 ; U =205.000,P =0.029).The BCVA after surgery was elevated in both groups (Z=-2.729,P =0.006 ; Z =-3.273,P =0.001).The rates of recurrent RD and macular hole closed were no difference between two groups(P=0.894,1.000).There were no other complications but cataract.Conclusions C3F8 tamponade of MHRD in high myopic eyes show the same efficacy as silicone oil tamponade.
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PURPOSE: To determine the results of pars plana vitrectomy and silicone oil tamponade to treat retinal detachment caused by macular holes in highly myopic eyes. METHODS: Eighteen highly myopic patients with spontaneous retinal detachment due to macular holes underwent vitrectomy and primary silicone oil tamponade. Preoperative statuses and postoperative results were reviewed. All patients had high myopia with axial lengths longer than 28 mm or had definite staphyloma. The average follow-up period was 24 months. RESULTS: Successful retinal attachment of the retina was achieved in 17 eyes, though 1 eye had redetached. Of the 17 eyes, 13 eyes achieved anatomical macular hole closure and 7 eyes showed improved visual acuity. CONCLUSIONS: Vitrectomy and silicone oil tamponade for retinal detachment due to macular holes in highly myopic eyes produce good anatomical and functional results.
Subject(s)
Humans , Eye , Follow-Up Studies , Myopia , Retina , Retinal Detachment , Retinal Perforations , Retinaldehyde , Silicone Oils , Visual Acuity , VitrectomyABSTRACT
@#ObjectiveTo investigate the correlation between the surgical effect and clinical factors in retinal detachments with macular hole patients.Methods71 patients were picked up from the rhegmatogenous retinal detachment (RRD) database in our hospital. All patients were well informed with clinical data and followed up. Logistic regression statistical analysis was performed to analyze correlation between the effect of operation and clinical factors.ResultsAll patients obtained successful retinal replacement and macular hole closure, but retinal detachment was relapsed in 10 patients from 3 days to 3 years after operation. Effect of retinal replacement was related with proliferative vitreoretinopathy (PVR) grade and course (P<0.05), while eyesight improvement was related with PVR grade, age and course (P<0.05).ConclusionAge, PVR grade and course affect the surgical effect.