SURGICAL MANAGEMENT AND OUTCOMES OF LARGE HIGH MYOPIC MACULAR HOLES: Global Macular Hole Multicenter Study 3.
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Liu Tianyu, Abreu-Arbaje Nassim A, Andoh Joana, Arevalo J Fernando, Avci Remzi, Bach Bernardo, Bohorquez Maria C, Boldt H Culver, Boyce Timothy M, Carauni Ana L, Carla Matteo M, Chau Viet Q, Chou Hung-Da, Coche Adrienne, D'Alterio Francesco M, Fan Jason, Felfeli Tina, Ferrara Mariantonia, Ferreira Magno A, Goriup Carolina Galvá, Gotzaridis Stratos, Gregori Ninel Z, Habib Ahmed M, Han Ian C, Hsieh Yi-Ting, Inoue Makoto, Kadonosono Kazuaki, Kamei Motohiro, Karabas Levent V, Keeley Jacob, Kitahata Shohei, Kumar Sandeep, Lai Chi-Chun, Liu Bingqian, Lu Lin, Mahgoub Mohamed M, Mandelcorn Efrem, Mansour Ahmed, Mateo Carlos, Matoba Ryo, Morizane Yuki, Morozova Christine, Nawrocka Zofia A, Nawrocki Jerzy, Nehemy Marcio B, Nuesi Ronaldo, Okonkwo Ogugua N, Tokuc Ecem O, Ozdek Sengul, Zeydanli Ece O, Park Jong G, Parolini Barbara, Patelli Fabio, Raizada Seemant, Rashingkar Revati, Reifschneider Eugen, Rezende Flavio A, Rizzo Stanislao, Romano Mario R, Russell Stephen R, Sabti Khalid A, Sandinha Teresa, Sauer Lydia, Savastano Alfonso, Shroff Daraius, Sohn Elliott H, Steel David H, Szurman Peter, Tabandeh Homayoun, Than Jonathan, Thangamathesvaran Loka, Tsuboi Kotaro, Tsui Mei-Chi, Viana Ana R, Walsh Hannah, Williams George A, Williamson Tom H, Xi Chen, Yang Chung-May, Yildiz Aysegul M, Yokoi Tadashi, Yonekawa Yoshihiro, Zampogianni Androniki, Mahmoud Tamer H
Аннотация
METHODS: Global multicenter retrospective case series of HMMHs with minimum linear diameter ≥ 400 µ m undergoing surgery between 2013 and 2023 with follow-up ≥ 3 months. The main outcome measure was the HMMH closure rate at postoperative Month 3.
RESULTS: Four hundred and ninety-nine cases of 463 patients from 37 surgeons were included, with mean ± SD age 58.3 ± 12.2 years, 77.0% female, 77.4% primary, 22.6% refractory, and mean ± SD follow-up 18.8 ± 20.2 months. The mean ± SD (range) minimum linear diameter was 649 ± 280 (400, 2,759) µ m. Surgery techniques included 127 internal limiting membrane peels, 285 internal limiting membrane flaps, 19 amniotic membrane transplantations, 36 autologous retinal transplantations, and 32 others. The postoperative Month 3 closure rate for all cases was 72.4%. Closure rates significantly decreased with greater CLOSE Study Group size classification for HMMHs treated with internal limiting membrane peeling or internal limiting membrane flap ( P = 0.006) but not for HMMHs treated with amniotic membrane transplantations or autologous retinal transplantations ( P > 0.05). Visual acuity significantly increased from baseline to each follow-up time point among all eyes, with a final mean ± SD change in visual acuity of -0.29 (0.55) logMAR (+14.5 early treatment diabetic retinopathy study letters), which did not significantly differ by surgery type.
CONCLUSION: High myopic macular hole closure rates are lower than those reported for macular holes in nonhighly myopic eyes, but most eyes can still achieve anatomical closure and meaningful visual acuity gains when treated with the appropriate technique.