Macular hole repair by vitrectomy and internal limiting membrane peeling in highly myopic eyes

PURPOSE:: To evaluate the surgical outcomes of macular hole (MH) repair by vitrectomy and internal limiting membrane peeling in highly myopic eyes. METHODS:: In this retrospective interventional case series, 30 highly myopic eyes with MH in 29 consecutive patients who underwent vitrectomy and internal limiting membrane peeling to repair MH were studied. The mean follow-up time was 36.4 months. The anatomical outcomes of the MH were evaluated by optical coherence tomography. The best-corrected visual acuities before and after surgery were compared as the functional outcome. RESULTS:: Women accounted for 69% of MH in highly myopic eyes. The mean age was 49 years. The mean refraction error and mean axial length were -9.80 (±2.93) diopter and 28.13 (±2.41) mm, respectively. Myopic foveoschisis was observed in 3 eyes (10%). The MHs were closed by a single surgery in 26 eyes (87%), and the final closure rate was 97% (29/30 eyes). Macular hole surgery significantly improved best-corrected visual acuity from 1.20 ± 0.70 to 0.77 ± 0.51 logarithm of the minimum angle of resolution (P = 0.003). However, rhegmatogenous retinal detachment developed in 3 eyes (10%) during the follow-up. CONCLUSION:: Vitrectomy with internal limiting membrane peeling is effective to repair MH in highly myopic eyes in terms of anatomical and functional outcomes, although visual acuity may continue to improve slowly until 3 years after successful MH-closing surgery. In addition, a small proportion of MH cases were associated with myopic foveoschisis. Delayed hole closure and rhegmatogenous retinal detachment may occur in these highly myopic eyes after surgery.