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      Macular Hole in Myopic Eyes: A Narrative Review of the Current Surgical Techniques

      review-article
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      Journal of Ophthalmology
      Hindawi

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          Abstract

          Macular hole (MH) in myopic eyes is a disease arising from complex tractional forces exerted by vitreomacular interface, epiretinal tissue, and progressive scleral ectasia of the posterior ocular globe wall. This retinal disease requires vitreoretinal treatment for its repair, and the surgical intervention remains a challenge also for experienced surgeons. The aim of this review is to describe the current knowledge regarding the pathogenesis of MH in myopic eyes and to detail novel surgical techniques and technological advancements in its surgical management.

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          Most cited references132

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          Vitreous surgery for idiopathic macular holes. Results of a pilot study.

          Idiopathic macular holes are generally considered an untreatable condition. We used modern vitrectomy techniques to evaluate two questions: (1) Is it possible to reattach the retina around the macular hole? (2) If it is reattached, will the patient's central vision improve? In 30 (58%) of 52 patients, we were able to reattach successfully the detached macula with our surgical procedure. In 22 (73%) of the 30 patients in whom the macula was successfully reattached, there was an improvement in visual acuity of two lines or better. In the 22 patients in whom reattachment of the macular hole was not obtained, there was no significant improvement in visual acuity. Thus, the overall success rate for improved vision postoperatively was 42% (22/52). Complications related to surgery were observed in eight patients (15%) early in our experience with this procedure and included increase in the size of the macular hole, mottling of the retinal pigmented epithelium, and a vascular occlusion. Our clinical observations indicate that the treatment of macular holes by vitrectomy may offer some promise for this otherwise untreatable condition. In patients in whom reattachment was successful, the technique used appeared to allow for clinically significant improvements in visual acuity. However, additional work on increasing surgical success and minimizing surgical complications, as well as a further understanding of the mechanism of retinal reattachment, is required before widespread use of this procedure for treating macular holes.
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            Autologous transplantation of the internal limiting membrane for refractory macular holes.

            To determine the effectiveness of autologous transplantation of the internal limiting membrane (ILM) for refractory macular holes.
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              Vitreous Surgery for Idiopathic Macular Holes

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                Author and article information

                Contributors
                Journal
                J Ophthalmol
                J Ophthalmol
                JOPH
                Journal of Ophthalmology
                Hindawi
                2090-004X
                2090-0058
                2019
                11 March 2019
                : 2019
                : 3230695
                Affiliations
                Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
                Author notes

                Guest Editor: Claudio Azzolini

                Author information
                http://orcid.org/0000-0001-7033-1911
                Article
                10.1155/2019/3230695
                6432738
                30984418
                e3aa3f75-6a69-4dba-9a40-ac127e1b4792
                Copyright © 2019 Chiara De Giacinto et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 November 2018
                : 21 February 2019
                Categories
                Review Article

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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