Comparison of Intraocular Tamponade in Patients with Peripheral Tear-Induced Retinal Detachment and Coexisting Macular Hole without High Myopia

Abstract

Introduction To introduce the surgical results and examine the effect of intraocular tamponades on surgical outcomes in patients with coexisting macular hole (MH) and rhegmatogenous retinal detachment (RRD) without high myopia.

Methods This retrospective, cross-sectional, two-center study was carried out with 29 eyes of 29 patients. The patients were divided into two groups according to the intraocular tamponade used in surgery: silicone oil (Group 1) and C₃F₈ gas (Group 2). In all patients, the internal limiting membrane was peeled during surgery. Exclusion criteria were determined as RRD with MH due to high myopia (≥ 6 D) without peripheral retinal tears and traumatic MH.

Results In Group 1, the median preoperative best-corrected visual acuity (BCVA) was 3.0 (M ± SD: 2.85 ± 0.27) logMAR, while the median postoperative BCVA was 1.0 (M ± SD: 1.39 ± 0.83) logMAR (p < 0.001). In Group 2, the median preoperative BCVA was 3.0 (M ± SD: 2.37 ± 0.93) logMAR, while the median postoperative BCVA was 0.76 (M ± SD: 1.06 ± 0.86) logMAR (p = 0.008). The retinal attachment success rate was 15/17 (89.3%) in Group 1, and 11/12 (91.7%) in Group 2 (p = 0.64). The MH closure rate was 12/17 (71.6%) in Group 1, and 10/12 (78.1%) in Group 2 (p = 0.52). No difference was determined between the groups in terms of preoperative and postoperative BCVA, preoperative and postoperative intraocular pressure, and BCVA improvement.

Conclusions The study results showed no significant difference between using silicone oil or C₃F₈ gas as an intraocular tamponade after internal limiting membrane peeling in patients with RRD due to peripheral tear with coexisting MH.

Zusammenfassung

Einführung Vorstellung der Operationsergebnisse und Untersuchung der Wirkung von intraokularen Tamponaden auf die Operationsergebnisse bei Patienten mit Makulaforamen (MH) und rhegmatogener Netzhautablösung (RRD) ohne hohe Myopie.

Methoden Diese retrospektive Querschnittsstudie wurde an 2 Zentren mit 29 Augen von 29 Patienten durchgeführt. Die Patienten wurden entsprechend der bei der Operation verwendeten intraokularen Tamponade in 2 Gruppen eingeteilt: Silikonöl (Gruppe 1) und C₃F₈-Gas (Gruppe 2). Bei allen Patienten wurde die innere Grenzmembran während der Operation gepeelt. Ausschlusskriterien waren RRD aufgrund MH ohne periphere Netzhautrisse bei hoher Myopie (≥ 6 dpt) und traumatisches MH.

Ergebnisse In Gruppe 1 betrug der präoperative bestkorrigierte Visus (BCVA) 3,0 (M ± SD: 2.85 ± 0.27) logMAR, während der postoperative BCVA 1,0 logMAR (M ± SD: 1.39 ± 0.83) betrug (p < 0.001). In Gruppe 2 betrug die präoperative BCVA 3.0 (M ± SD: 2.37 ± 0.93) logMAR, die postoperative BCVA betrug 0.76 (M ± SD: 1.06 ± 0.86) logMAR (p = 0.008). Die Erfolgsrate der primären Nertzhautanlage lag bei 15/17 (89.3%) in Gruppe 1, 11/12 (91.7%) in Gruppe 2 (p = 0.64). Die MH-Verschlussrate erreichte 12/17 (71.6%) in Gruppe 1, 10/12 (78.1%) in Gruppe 2 (p = 0.52). Es zeigte sich kein Unterschied in Bezug auf präoperative und postoperative BCVA, präoperativen und postoperativen Augeninnendruck, BCVA-Verbesserung zwischen den beiden Gruppen.

Schlussfolgerungen Unsere Ergebnisse zeigen keinen signifikanten Unterschied zwischen der Verwendung von Silikonöl oder C₃F₈-Gas als intraokulare Tamponade nach einem Peeling der inneren Grenzmembran bei Patienten mit RRD aufgrund von peripherem Netzhautlöcher und gleichzeitig vorhandenem MH.

Conclusion Box

Already known:

• There are no data about the surgical outcomes of patients with peripheral tear-induced retinal detachment with coexisting MH without high myopia in the literature.

Newly described:

• PPV plus ILM peeling is a very safe and effective method in MH coexisting secondary to retinal detachment without high myopia, which is quite complex and problematic.

• There is no significant difference between silicone oil or C₃F₈ gas as an intraocular tamponade after ILM peeling in patients with peripheral tear-induced retinal detachment with coexisting MH without high myopia.

• Silicone oil does not have a significant superiority over C₃F₈ in cases with peripheral tear-induced retinal detachment with coexisting MH without high myopia.

Key words

internal limiting membrane - rhegmatogenous retinal detachment - vitrectomy - macular hole

Schlüsselwörter

Vitrektomie - rhegmatogene Netzhautablösung - innere Grenzmembran - Makulaforamen

Publication History

Received: 15 August 2022

Accepted: 27 October 2022

Accepted Manuscript online:
27 October 2022

Article published online:
12 January 2023

• References

• 1 Parravano M, Giansanti F, Eandi CM. et al. Vitrectomy for idiopathic macular hole. Cochrane Database Syst Rev 2015; (05) CD009080
• 2 Wang S, Xu L, Jonas JB. Prevalence of full-thickness macular holes in urban and rural adult Chinese: the Beijing Eye Study. Am J Ophthalmol 2006; 141: 589-591
• 3 Jackson TL, Donachie PHJ, Sparrow JM. et al. United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 2, macular hole. Ophthalmology 2013; 120: 629-634
• 4 Budoff G, Bhagat N, Zarbin MA. Traumatic Macular Hole: Diagnosis, Natural History, and Management. J Ophthalmol 2019; 2019: 5837832
• 5 Schumann RG, Wolf A, Hoerauf H. et al. Vitrectomy for Persistent Macular Holes Following Ocriplasmin Injection: A Comparative Multicenter Study. Retina 2017; 37: 2295-2303
• 6 Cunningham MA, Tarantola RM, Folk JC. et al. Proliferative vitreoretinopathy may be a risk factor in combined macular hole retinal detachment cases. Retina 2013; 33: 579-585
• 7 Najafi M, Brown JS, Rosenberg KI. Increased Reoperation Rate in Surgical Treatment of Rhegmatogenous Retinal Detachment with Coexistent Macular Hole. Ophthalmol Retina 2018; 2: 187-191
• 8 Oie Y, Emi K, Takaoka G. et al. Effect of indocyanine green staining in peeling of internal limiting membrane for retinal detachment resulting from macular hole in myopic eyes. Ophthalmology 2007; 114: 303-306
• 9 Schumann RG, Langer J, Compera D. et al. Assessment of intravitreal ocriplasmin treatment for vitreomacular traction in clinical practice. Graefes Arch Clin Exp Ophthalmol 2017; 255: 2081-2089
• 10 Schwartz SG, Flynn jr. HW, Wang X. et al. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy. Cochrane Database Syst Rev 2020; (05) CD006126
• 11 Ryan jr. EH, Bramante CT, Mittra RA. et al. Management of rhegmatogenous retinal detachment with coexistent macular hole in the era of internal limiting membrane peeling. Am J Ophthalmol 2011; 152: 815-819.e1
• 12 Abouhussein MA, Elbaha SM, Aboushousha M. Human Amniotic Membrane Plug for Macular Holes Coexisting with Rhegmatogenous Retinal Detachment. Clin Ophthalmol 2020; 14: 2411-2416
• 13 Duker JS, Kaiser PK, Binder S. et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 2013; 120: 2611-2619
• 14 Park DW, Lee JH, Min WK. The use of internal limiting membrane maculorrhexis in treatment of idiopathic macular holes. Korean J Ophthalmol 1998; 12: 92-97
• 15 Brooks jr. HL. Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology 2000; 107: 1939-1948
• 16 Shukla D, Kalliath J, Srinivasan K. et al. Management of rhegmatogenous retinal detachment with coexisting macular hole: a comparison of vitrectomy with and without internal limiting membrane peeling. Retina 2013; 33: 571-578
• 17 Chen SN, Yang CM. Perfluorocarbon Liquid-Assisted Neurosensory Retinal Free Flap for Complicated Macular Hole Coexisting with Retinal Detachment. Ophthalmologica 2019; 242: 222-233
• 18 Lyu J, Xia F, Zhao P. Intraoperative Perfluorocarbon Liquid Tamponade Technique for Treatment of Extensive Retinal Detachment Secondary to a Myopic Macular Hole. Retina 2022;
• 19 Ichibe M, Yoshizawa T, Murakami K. et al. Surgical management of retinal detachment associated with myopic macular hole: anatomic and functional status of the macula. Am J Ophthalmol 2003; 136: 277-284
• 20 OʼDriscoll AM, Goble RR, Kirkby GR. Vitrectomy for retinal detachments with both peripheral retinal breaks and macular holes. An assessment of outcome and the status of the macular hole. Retina 2001; 21: 221-225
• 21 Nishimura A, Kita K, Segawa Y. et al. Perfluorocarbon liquid assists in stripping the ILM to treat detached retina caused by macular hole. Ophthalmic Surg Lasers 2002; 33: 77-78
• 22 Uemoto R, Yamamoto S, Tsukahara I. et al. Efficacy of internal limiting membrane removal for retinal detachments resulting from a myopic macular hole. Retina 2004; 24: 560-566
• 23 Chen YP, Chen TL, Yang KR. et al. Treatment of retinal detachment resulting from posterior staphyloma-associated macular hole in highly myopic eyes. Retina 2006; 26: 25-31