Clinical presentation and surgical outcomes in primary myopic macular hole retinal detachment.

Purpose: To describe the clinical presentation of primary macular hole retinal detachment (MHRD) secondary to high myopia and to evaluate the surgical outcomes.

Methods: Nine eyes of 9 patients with primary myopic MHRD (axial length =26.5 mm) were enrolled. A standardized surgical protocol was performed using vitrectomy with preservative-free triamcinolone acetonide-assisted internal limiting membrane (ILM) peeling and silicone oil tamponade and were followed for at least 6 months from the first surgery.

Results: There were 6 women and 3 men with a median age of 52 years. Six (66.6%) patients presented with inferior bullous configuration and 3 had subtotal retinal detachment. The mean preoperative refractive error (spherical equivalent) and mean axial length was 12 ± 3.553 D (range 8.50-19.50) and 28.13 ± 1.65 mm (range 26.50-31.50), respectively. The patients were followed up for a period of at least 6 months. The retina was attached and macular hole closed in all the eyes. There was significant visual acuity improvement from mean preoperative visual acuity of logMAR 1.85 ± 0.11 (range 1.76-1.93) to postoperative visual acuity of logMAR 0.95 ± 0.14 (range 0.84-1.06) (p<0.001).

Conclusions: Retinal detachment in highly myopic eyes can often be secondary to a macular hole with predominance of inferior bullous configuration and primary vitrectomy with ILM peeling with silicone oil tamponade results in good anatomic and functional outcomes.