Evaluation of the clinical effectiveness of silicone oil removal in high myopia with macular hole by optical coherence tomography / 中华实验眼科杂志

ABSTRACT

Background The recurrent rate of retinal detachment is much higher after silicone oil removal in high myopia with macular hole.How reduce the recurrence is a hot topic.Whether optical coherence tomography (OCT)-assisted examination is helpful for the improvement of surgery successful rate is in clinical observation ObjectiveThis study was to observe macular retinal status before silicone oil removal in eyes with macular holerelated retinal detachment in highly myopic eyes by OCT and evaluate the factors that influence successful silicone oil removal.MethodsFifty-five eyes of 49 consecutive patients who received vitreoretinal surgery for highly myopic retinal detachment caused by macular hole from January 2005 to December 2008 were involved,and 45 eyes of 40 patients who underwent silicone oil tamponade were retrospectively analyzed.Three to six months after vitreoretinal surgery combined with silicone oil tamponade,removal of silicone oil was performed based on the macular appearance on the OCT and the patients were followed up for over 1 year.The OCT manifestation of macular hole and the best corrected visual acuity (BCVA) were compared between before vitrectomy combined with silicone oil tamponade surgery,and after removal of silicone oil.The healing of the macular hole was classified into type Ⅰ and Ⅱ healing according to the OCT results.ResultsThe retina at the macular area completely reattached in 40 eyes(88.89％ )before removal of silicone,and the margin of the macular hole had disappeared in 2 of the 40 eyes,showing type Ⅰ heal.Thirty-eight eyes were determined to exhibit type Ⅱ healing,presenting with a visible hole margin and local defection of nervous fiber layer.Two years after the removal of silicone,retinal detachment reappeared in 1 eye with type Ⅱ heal.The BCVAs were 1.93±0.06 and 1.16±0.07 before and 1 year after removal of silicone,respectively,showing a significant difference between them(P =0.00).ConclusionsOCT is a useful tool for the prediction of anatomic outcomes in macular hole-related retinal detachment eyes with high myopia.Silicone oil removal can be performed in macular hole closure eye or attached-well hole edge eye based on OCT examination.However,attachedwell hole edge eye should receive longer follow-up time.