BACKGROUND AND OBJECTIVES:To evaluate the visual and anatomical outcomes of surgery for retinal detachment due to macular hole in highly myopic eyes with pronounced posterior staphyloma. PATIENTS AND METHODS:Data for all patients with high myopia who underwent surgery for retinal detachment resulting from macular hole from 1993 to 2002 in one hospital were evaluated. Patient characteristics, best-corrected visual acuity preoperatively and at last examination, surgical technique, anatomical success, and follow-up period were extracted and analyzed statistically. RESULTS:Twenty-six of the 27 patients (28 eyes) were female (96%) with a mean age of 59.8 years; mean follow-up was 17.3 months. Mean axial length was 29.1+/-2.74 mm; mean myopia was -16.4 +/- 3.1 diopters. Marked posterior staphyloma was detected in 71%. Seven eyes had undergone failed scleral buckling as the primary procedure; intravitreal SF6 injection was the primary procedure in 12 eyes. Twenty-three eyes underwent deep vitrectomy with use of high viscosity silicone oil. Overall anatomical success was achieved in 92.9% (26 of 28 eyes); 78.6% had visual improvement. CONCLUSIONS:Vitreous surgery combined with other necessary adjunct procedures such as membrane peeling and use of retinal tamponade, as a primary or a secondary procedure, seems to be successful in achieving retinal reattachment in eyes with macular hole and posterior staphyloma.

译文

背景与目的:评价高度近视眼伴有明显葡萄球菌的高度近视眼黄斑裂孔引起的视网膜脱离的手术的视觉和解剖学结果。
病人和方法:对1993年至2002年在一家医院中接受黄斑裂孔性视网膜脱离手术的所有高度近视患者的数据进行了评估。提取患者特征,术前和最后检查的最佳矫正视力,手术技术,解剖学成功率和随访时间,并进行统计学分析。
结果:27例患者中有26例(28只眼)为女性(96%),平均年龄为59.8岁。平均随访17.3个月。平均轴向长度为29.1 /-2.74 mm;平均近视为-16.4 /-3.1屈光度。检出明显的后葡萄球菌占71%。七只眼的巩膜屈曲失败是主要手术。玻璃体内SF6注射是12眼的主要手术。使用高粘度硅油对二十三只眼睛进行了深玻璃体切除术。总体解剖学成功率为92.9%(28眼中的26眼); 78.6%的视力有所改善。
结论:玻璃体手术结合其他必要的辅助手术(例如膜剥离和视网膜填塞术的使用)作为主要手术或继发手术,似乎成功地实现了黄斑裂孔和后葡萄球菌病的视网膜复位。

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