Anatomical and visual outcome after vitrectomy with triamcinolone acedonide-assisted epiretinal membrane removal in highly myopic eyes with retinal detachment due to macular hole

Abstract

Purpose: To determine the effectiveness of staining an epiretinal membrane (ERM) with triamicinolone acedonide (TA) during vitrectomy for a retinal detachment (RD) due to a macular hole (MH) in highly myopic eyes. Patients and methods: Thirty-four highly myopic eyes (>-6.0 dioptres) of 34 patients with an RD caused by an MH underwent vitrectomy with TA-assisted ERM removal. The excised ERMs from five eyes were examined by transmission electron microscopy (TEM). The main outcome measures were the retinal status and best-corrected visual acuity (BCVA). The anatomic status of the MH was determined by optic coherence tomography (OCT) in 24 successfully retinal-reattached eyes. The follow-up periods ranged from 5 to 20 months. Results: The granules of TA adhered to the ERM and the residual posterior hyaloid, which made them more visible and facilitated their removal. Tissues resembling the internal limiting membrane were not detected in any of the five excised tissues. The retinal reattachment rate was 88% after the first surgery. The mean log MAR BCVA significantly improved from 1.83±0.50 (mean±SD) before surgery to 1.22±0.35 at the final follow-up (P<0.001, Wilcoxon signed rank test). OCT showed a normal concave appearance in 11 of 24 eyes (46%), but a central neural epithelial defect was present in 13 of 24 eyes (54%). Conclusions: TA facilitates the complete removal of both the ERM and residual posterior hyaloid, thus ensuring high anatomical and visual success rates in highly myopic eyes with an RD due to MH. © 2009 Macmillan Publishers Limited All rights reserved.