Scleral resection technique combined with vitrectomy for a macular hole retinal detachment in highly myopic eyes.

PURPOSE: To evaluate scleral resection technique combined with vitrectomy for macular hole retinal detachment of highly myopic eyes. MATERIALS AND METHODS: Seventeencases (17 eyes) of macular hole retinal detachment in highly myopic eyes, in which the patient underwent vitrectomy combined with scleral resection technique formacular hole retinal detachment between January 1996 and December 2003 at Fukuoka University Chikushi Hospital, were studied. Following pars plana vitrectomy, as much as possible of the residual vitreous and/or epiretinal membrane was removed. A scleral resection was performed in 2 quadrants of the equatorial region of the temporal sclera. Finally, a fluid-air exchange with SF(6) gas injection was performed to achieve retinal attachment. Pre- and postoperative axial length of the eyeballs were measured by B-scan ultrasonography. RESULTS: All cases had the retina reattached at the initial surgery, and visual acuities were stabilized or improved after the surgery. The posterior staphyloma became obscure in 13 out of 17 eyes (76.8%). The macular hole closed in 14 of 17 eyes (82.4%) ophthalmoscopically. There were no cases in which retinal redetachment occurred during follow-up periods of more than 6 months. CONCLUSION: In cases of macular hole retinal detachment of a highly myopic eye, scleral resection technique combined with vitrectomy changed the shape of the eyeballs and allowed successful retinal reattachment at the initial surgery.

Long-term results of pars plana vitrectomy combined with filtering surgery for neovascular glaucoma.

BACKGROUND AND OBJECTIVE: To analyze the effectiveness of vitrectomy combined with filtering surgery for neovascular glaucoma. PATIENTS AND METHODS: Twenty-one eyes with neovascular glaucoma underwent pars plana vitrectomy combined with filtering surgery between January 1995 and December 2003. Thirteen eyes (10 cases) had neovascular glaucoma secondary to proliferative diabetic retinopathy and 8 eyes (8 cases) had neovascular glaucoma secondary to central retinal vein occlusion. The initial intraocular pressures ranged from 21 to 70 mm Hg with full medication. All cases were observed for more than 12 months after the last surgery and the ophthalmic records were retrospectively reviewed. RESULTS: During the follow-up period, 19 eyes (90.5%) had intraocular pressures of less than 21 mm Hg with or without antiglaucoma eye drops, whereas 18 eyes (85.7%) had a stable or improved visual acuity. CONCLUSION: Vitrectomy combined with filtering surgery is considered to be an effective treatment for neovascular glaucoma to maintain the visual function for a long period.