SCLERAL IMBRICATION COMBINED WITH VITRECTOMY AND GAS TAMPONADE FOR REFRACTORY MACULAR HOLE RETINAL DETACHMENT ASSOCIATED WITH HIGH MYOPIA

Purpose: To evaluate scleral imbrication with vitrectomy and gas tamponade for refractory macular hole retinal detachment associated with high myopia. Methods: We retrospectively reviewed the medical records of eight eyes with macular hole retinal detachment and high myopia treated with temporal scleral imbrication, pars plana vitrectomy, and gas tamponade for refractory macular hole retinal detachment with history of pars plana vitrectomy. Retinal reattachment and macular hole closure were assessed. Postoperative changes in axial length and surgically induced astigmatism were evaluated. Results: The retinas were reattached in all eyes and the macular holes closed in 6 (75%) eyes. The mean baseline logarithm of the minimum angle of resolution best-corrected visual acuity of 1.43 +/- 0.48 significantly (P < 0.01) improved to 0.87 +/- 0.34 at the final visit (889 +/- 173 postoperative days). The mean baseline axial length of 29.5 +/- 1.3 mm decreased significantly (P < 0.01) to 27.1 +/- 1.9 mm 1 month after scleral imbrication and 28.1 +/- 1.7 mm at the final visit (P < 0.05 vs. baseline, P = 0.13 vs. 1 month). The mean 1-month surgically induced astigmatism of 3.6 +/- 1.4 diopters (D) after scleral imbrication significantly (P < 0.05) decreased to 2.4 +/- 1.5 D at the final visit. Conclusion: Scleral imbrication with vitrectomy and gas tamponade resulted in high reattachment and macular hole closure rates for treating refractory macular hole retinal detachment.