Anatomic evaluation of macular holes with silicone oil tamponades in highly myopic eyes using optical coherence tomography.

PURPOSE

To observe the postoperative status of the macula after vitrectomy with silicone oil tamponade for macular hole-related retinal detachment in highly myopic eyes by optical coherence tomography (OCT), to analyze the factors associated with anatomic success, and to evaluate the possibility of successful silicone oil removal.

METHODS

OCT was used to follow the postoperative changes in the macular area of 51 highly myopic eyes, and other information was obtained from patient records.

RESULTS

OCT confirmed that successful retinal reattachment was achieved in 41 eyes (80.4%) after the initial surgery, and all of them underwent silicone oil removal postoperatively. The macular holes were closed in 20 eyes (20/41), all of which remained retina attached after silicone oil removal. In 21 (21/41) macular hole nonclosed eyes, recurrent retinal detachment (RRD) occurred in 8 eyes (8/21) after silicone oil removal. There were statistically significant association between posterior staphyloma and the presence of macular hole (p<0.001). Macular hole closure significantly increased the chances of successful silicone oil removal (p=0.003). Improved postoperative best-corrected visual acuity was significantly associated with macular hole closure (p=0.012).

CONCLUSIONS

OCT helps predict anatomic and functional outcomes of highly myopic eyes with macular hole-related retinal detachment. Posterior staphyloma may prevent macular hole closure. Silicone oil removal can be performed when macular hole closure was confirmed by OCT, while in eyes with nonclosed macular holes, silicone oil removal may lead to RRD.