Macular buckling combined with inverted internal limiting membrane flap technique and air tamponade in the treatment of macular hole retinal detachment in high myopia.

Objective: The study aims to assess the efficacy of integrating macular buckling (MB) with pars plana vitrectomy (PPV), the inverted internal limiting membrane (ILM) flap technique, and air tamponade in treating macular hole retinal detachment (MHRD) in patients with high myopia.

Methods: This retrospective study included sixty-two eyes from sixty-two consecutive patients diagnosed with highly myopic MHRD. The participants were categorized into two groups: the PPV group (n=34) and the combination group (n=28). Best-corrected visual acuity (BCVA), axial length (AL), progression of myopic maculopathy (MM), rates of macular hole (MH) closure and retinal reattachment were assessed and compared.

Results: The mean follow-up duration was 14.13±2.57 months. The combination group demonstrated a significant higher rate of MH closure compared to the PPV group (79.41% vs. 100%, P=0.011). Retinal reattachment was successfully achieved in 100% of eyes in the combination group following the initial surgery, in contrast to 70.59% in the PPV group (P=0.002). The combination group demonstrated a significantly greater improvement in BCVA compared to the PPV group (P<0.001). The mean MM stage in the PPV group increased from 2.12±0.69 to 2.38±0.92 (P=0.031). The combination group exhibited no significant progression of MM postoperatively.

Conclusions: The integration of MB with the inverted ILM flap technique and air tamponade seems to enhance both MH closure and retinal reattachment rates, along with notable improvements in BCVA among patients with highly myopic MHRD. Keywords: Macular buckling, Pars plana vitrectomy, Inverted internal limiting membrane flap, Air tamponade, Macular hole retinal detachment.