Anatomical and visual outcomes of pars plana vitrectomy combined with
inverted internal limiting membrane flap technique and perfluoropropane
tamponade in high myopia macular holes with or without foveoschisis.
Purpose: To evaluate the efficacy and safety of vitrectomy combined with
inverted internal limiting membrane (ILM) flap technique and
perfluoropropane tamponade (C3F8) for the treatment of high myopia
macular holes (HMMH) with or without macular foveoschisis (MF). Methods:
This is a retrospective, observational case series study. Sixty-seven
eyes of 67 patients who underwent vitrectomy with inverted ILM flap and
C3F8 tamponade were enrolled. The main outcome measures were
best-corrected visual acuity (BCVA), the closure rate of HMMH and the
integrity of ellipsoid zone (EZ) and external limiting membrane (ELM) at
the final follow-up visit. Results：There was no significant difference
in the BCVA and the closure rate of HMMH at the final follow-up between
the two groups. However, the recovery of ELM and EZ was significantly
higher in the no MF group than in the MF group at the final follow-up.
Specifically, ELM and EZ were restored in 17 eyes (50.0%) and 10 eyes
(29.4%) of the no MF group, respectively, while only 4 eyes (12.1%)
and 2 eyes (6.1%) of the MF group achieved ELM and EZ restoration,
respectively. Conclusion: Vitrectomy with inverted ILM flap technique
and C3F8 tamponade is an effective and safe method to achieve a high
anatomical success rate of HMMH closure and improve visual function.
However, the presence of foveoschisis may impair the structural recovery
of the outer retinal layer.