Vitrectomy in high myopia: a narrative review

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Pathologic myopia is associated with degenerative changes of the globe, especially at the posterior pole. Eyes affected by pathologic myopia have higher odds to undergo posterior segment surgery and, in those eyes, vitreoretinal surgery is challenging. Many practical tips and tricks can make the surgical procedures simpler, significantly preventing sight-threatening intra- and post-operative complications. Moreover, novel surgical techniques and technological advancements (i.e. ad-hoc instrumentation, minimally invasive vitreoretinal surgery, filters, dye staining, intraoperative optical coherence tomography and 3-dimensional surgery) may play role in highly myopic eyes. The aim of the present work is to review practical tips and tricks, novel surgical techniques and technological advancements.

Electronic supplementary material

The online version of this article (doi:10.1186/s40942-017-0090-y) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 119

Record: found
Abstract: found
Article: not found

Inverted internal limiting membrane flap technique for large macular holes.

Zofia Michalewska, Janusz Michalewski, Ron Adelman … (2010)

Large macular holes usually have an increased risk of surgical failure. Up to 44% of large macular holes remain open after 1 surgery. Another 19% to 39% of macular holes are flat-open after surgery. Flat-open macular holes are associated with limited visual acuity. This article presents a modification of the standard macular hole surgery to improve functional and anatomic outcomes in patients with large macular holes. A prospective, randomized clinical trial. Patients with macular holes larger than 400 μm were included. In group 1, 51 eyes of 40 patients underwent standard 3-port pars plana vitrectomy with air. In group 2, 50 eyes of 46 patients underwent a modification of the standard technique, called the inverted internal limiting membrane (ILM) flap technique. In the inverted ILM flap technique, instead of completely removing the ILM after trypan blue staining, a remnant attached to the margins of the macular hole was left in place. This ILM remnant was then inverted upside-down to cover the macular hole. Fluid-air exchange was then performed. Spectral optical coherence tomography and clinical examination were performed before surgery and postoperatively at 1 week and 1, 3, 6, and 12 months. Visual acuity and postoperative macular hole closure. Preoperative mean visual acuity was 0.12 in group 1 and 0.078 in group 2. Macular hole closure was observed in 88% of patients in group 1 and in 98% of patients in group 2. A flat-hole roof with bare retinal pigment epithelium (flat-open) was observed in 19% of patients in group 1 and 2% of patients in group 2. Mean (or median) postoperative visual acuity 12 months after surgery was 0.17 (range, 0.1-0.6) in group 1 and 0.28 (range, 0.02-0.8) in group 2 (P = 0.001). The inverted ILM flap technique prevents the postoperative flat-open appearance of a macular hole and improves both the functional and anatomic outcomes of vitrectomy for macular holes with a diameter greater than 400 μm. Spectral optical coherence tomography after vitrectomy with the inverted ILM flap technique suggests improved foveal anatomy compared with the standard surgery. Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

0 comments Cited 266 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Autologous transplantation of the internal limiting membrane for refractory macular holes.

Yuki Morizane, Fumio Shiraga, Shuhei Kimura … (2014)

To determine the effectiveness of autologous transplantation of the internal limiting membrane (ILM) for refractory macular holes.

0 comments Cited 96 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Optical coherence tomography findings in myopic traction maculopathy.

Giacomo Panozzo, Andrea Mercanti (2004)

To describe the features and incidence of epiretinal traction and related retinal damage in degenerative myopia. Consecutive observational case series. We retrospectively reviewed medical records and optical coherence tomography findings of 218 eyes with high myopia of 121 consecutive patients to detect the incidence and features of epiretinal traction-related macular damage. The degree of myopia ranged from -8 to -26 spherical equivalent (mean +/- SD, -16.93 +/- 5.74). Mean +/- SD axial length was 29.75 +/- 2.12 mm. Excluding eyes with possibly confounding features, 125 eyes were analyzed. Detection of epiretinal traction and related macular damage. Epiretinal traction was found in 58 (46.4%) of 125 eyes and retinal damage, in 43 eyes (34.4%). Macular retinoschisis was the most frequent form of macular damage (25 eyes [58%]), followed by retinal thickening, lamellar hole, and shallow retinal detachment. Epiretinal traction is a frequent finding in degenerative myopia and, particularly if associated with the presence of staphyloma, can generate a form of macular damage unique to eyes with high myopia. This damage can affect up to one third of these eyes and should be considered as a separate cause of visual loss easily detected by optical coherence tomography at its early stages.

0 comments Cited 93 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Michele Coppola: mich.coppola@gmail.com

Alessandro Rabiolo: rabiolo.alessandro@hsr.it

Maria Vittoria Cicinelli: cicinelli.mariavittoria@hsr.it

Giuseppe Querques: +390226432648 , giuseppe.querques@hotmail.it

Francesco Bandello: bandello.francesco@hsr.it

Journal

Journal ID (nlm-ta): Int J Retina Vitreous

Journal ID (iso-abbrev): Int J Retina Vitreous

Title: International Journal of Retina and Vitreous

Publisher: BioMed Central (London )

ISSN (Electronic): 2056-9920

Publication date (Electronic): 2 October 2017

Publication date PMC-release: 2 October 2017

Publication date Collection: 2017

Volume: 3

Electronic Location Identifier: 37

Affiliations

[1 ]ISNI 0000 0004 1760 8047, GRID grid.413643.7, Ophthalmology Unit, , Azienda Ospedaliera di Desio e Vimercate, ; Desio, Italy

[2 ]Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy

Article

Publisher ID: 90

DOI: 10.1186/s40942-017-0090-y

PMC ID: 5623972

PubMed ID: 29021916

SO-VID: fd733187-a31c-4893-985e-ad697a3f22fe

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 5 June 2017

Date accepted : 16 August 2017

Custom metadata

Keywords: degenerative myopia,epiretinal membrane,intraoperative optical coherence tomography,inner limiting membrane,inverted flap,macular hole,pathologic myopia,posterior staphyloma,pars plana vitrectomy,three-dimensional surgery

Data availability:

Keywords: degenerative myopia, epiretinal membrane, intraoperative optical coherence tomography, inner limiting membrane, inverted flap, macular hole, pathologic myopia, posterior staphyloma, pars plana vitrectomy, three-dimensional surgery

Vitrectomy in high myopia: a narrative review

Read this article at

Abstract

Electronic supplementary material

Related collections

Europe and the World: A law review

Most cited references 119

Inverted internal limiting membrane flap technique for large macular holes.

Autologous transplantation of the internal limiting membrane for refractory macular holes.

Optical coherence tomography findings in myopic traction maculopathy.

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 198

Cited by 8

Most referenced authors 985