Pars Plana Vitrectomy and Perfluoropropane (C3F8) Tamponade for Retinal Detachment Due to Myopic Macular Hole: A Prognostic Factor Analysis
Accepted 28 July 2006. published online 01 September 2006.
Purpose
To determine the prognostic factors associated with anatomical success in the treatment of retinal detachment (RD) due to myopic macular hole by pars plana vitrectomy (PPV) and perfluoropropane (C3F8) gas tamponade.
Design
Retrospective, interventional, comparative case series.
Methods
In an institutional setting, 57 eyes with myopic macular hole RDs treated by PPV and C3F8 tamponade, with or without concomitant internal limiting membrane (ILM) peeling, endolaser photocoagulation, and/or phacoemulsification, were analyzed. Outcome measures were anatomical success, defined as closure of macular hole with reattachment of the surrounding retina, and postoperative best-corrected visual acuity (BCVA).
Results
The mean postoperative follow-up was 26.9 ± 16.5 months. The anatomical success rate after primary PPV and C3F8 tamponade was 63.2%. Regression analysis showed that shorter axial lengths (odds ratio [OR] = 6.73, 95% confidence interval [95% CI] 1.86 to 12.22, P = .010), concomitant ILM peeling (OR 1.59, 95% CI 1.14 to 2.38, P = .013), and shorter duration of macular hole RD (OR 0.81, 95% CI 0.67 to 0.98, P = .033) were associated with a higher anatomical success. The mean pre- and postoperative BCVAs were 1.430 ± 0.273 (range, 0.523 to 1.700) and 1.403 ± 0.271 (range, 0.699 to 1.800) logarithm of minimal angle of resolution units, respectively. The postoperative BCVA was significantly better in eyes with macular hole closure than in eyes without (P = .021).
Conclusions
Axial length, concomitant ILM peeling, and duration were important prognostic factors for PPV and C3F8 tamponade in the treatment of myopic macular hole RDs.
Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, and Vitreoretinal Service, Hong Kong Eye Hospital, Hospital Authority Ophthalmic Services, Kowloon, Hong Kong.
Inquiries to Wico W. Lai, MD, FACS, Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, University Eye Centre, 3/F, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong
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