Primary gas tamponade in the management of macular hole with retinal detachment in highly myopic eyes.

Background: We conducted a retrospective study to investigate the role of the primary gas tamponade on the final success rate of macular hole with retinal detachment (MHRD) in highly myopic eyes.

Methods: Retrospective chart review of the patients diagnosed as MHRD in highly myopic eyes between 1992 and 2008 was done. Fifty-three highly myopic eyes (>-6.0 diopter, >26 mm of axial length, or visible posterior staphyloma) with a retinal detachment resulting from a macular hole were included. The main outcome measures were anatomic reattachment and final visual acuity.

Results: Thirty-two of the 53 eyes received primary gas tamponade, and the reattachment of retina was achieved in 8 eyes (8/32, 25%). Twenty-one of the 53 eyes received primary pars plana vitrectomy (PPV) with or without scleral buckle, and the reattachment of retina was achieved in 12 eyes (12/21, 57.1%). The final success rate after adjunctive operations was 96.9% in the primary gas tamponade group, and 85.7% in the primary PPV group. Stability of vision (improved or maintained) was achieved in 78.1% of the primary gas group, and 66.7% in the primary PPV group.

Conclusions: Our results indicate that primary gas tamponade does not decrease the final success rate in the repair of MHRD in highly myopic patients. Since it is safe and time-saving, primary gas tamponade could be a good alternative for primary treatment in those who are not willing or eligible for more complicated surgeries.