Evaluation Of The Efficacy And Prognostic Factoers Of Vitrectomy For Macular Hole Retinal Detachment In Myopia

Purpose To evaluate the value of Pars Plana Vitrectomy(PPV)combined with internal limiting membrane stripping/transplantation in the treatment of patients with high myopia macular hole retinal detachment(macular retinal detachment,MHRD),whether the patient’s axial axis is long and the vitreous is After complete detachment,whether there is a posterior scleral staphyloma and other conditions to analyze the impact of prognosis.Methods From January 2016 to January 2018,a total of 13 eyes of 13 patients with high myopia macular hole retinal detachment who were treated with vitrectomy at the Zhejiang Provincial People’s Hospital affiliated to Hangzhou Medical College,aged 47-75 years old,averaged The age was 60.1±7.97 years,the course of disease was from 1 to 24 months,and the average duration was 3.31±5.77 months.Postoperative follow-up was performed from March to June.The best corrected visual acuity(best corrected visual acuity,BCVA)before and after surgery,IOL-Master or A super-measurement of the axial axis,and the scleral staphyloma and vitreous of the eye B-ultrasound were recorded.Optical coherent tomography(OCT)was used to evaluate retinal reattachment and macular hole closure.The degree of improvement of BCVA before and after surgery was statistically correlated with the closure of the macular hole,course of disease,axial length,posterior scleral staphyloma,and posterior vitreous detachment.Results:All patients with high myopia with MHRD underwent PPV surgery.The retinal anatomical reduction was achieved.The rate of retinal reattachment was 100%.The macular hole was finally healed in all patients.The macular hole closure rate was 100%.The macular hole was completely healed in 5 cases,and the complete healing rate was 33.3.%,preoperative BCVA was(1.70±0.73)logMAR,postoperative BCVA was logMAR(1.17±0.37),and Wilcoxon rank sum test was used to compare postoperative BCVA significantly(P=0.01 5).The independent sample rank sum test compared the effect of macular hole healing on postoperative BCVA and found no significant correlation between the two(P=0.679).Multiple regression regression was used to establish the regression equations of preoperative and postoperative BCVA with age,gender,eye,axis of the eye and posterior vitreous detachment.It was found that preoperative visual acuity was not associated with age,gender,eye,axis of the eye and posterior vitreous detachment.Statistical correlation(both P>0.05).Postoperative visual acuity was related to the axial axis(P=0.011),but there was no statistical correlation with age,gender,eye,and posterior vitreous detachment(both P>0.05).Conclusion1.PPV combined with internal limiting membrane transplantation/exfoliation can effectively treat high myopia MHRD.When the retina is 100%,the visual acuity is also significantly improved.The macular hole closure rate is 100%,and the complete healing rate is 33.3%.;2.The axial length of the eye is significantly correlated with.the prognosis of vision,but the axial axis>30 mm is not a risk factor for poor prognosis.Whether the vitreous is detached is related to the improvement of preoperative visual acuity and postoperative visual acuity;3.Age,gender,eye,course of disease,posterior scleral staphyloma had no significant correlation with the healing of macular hole and the recovery of postoperative visual acuity.