Pars Plana Vitrectomy and Perfluoropropane (C₃F₈) Tamponade for Retinal Detachment Due to Myopic Macular Hole: A Prognostic Factor Analysis

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.