Hassan Mortada (Cairo, Egypt)

Advantages:

Factors acting in the production of macular hole RD in highly myopic eyes may include traction exerted by partially detached posterior hyaloid, altered ILM, potent retinal arterioles and progression of posterior staphyloma. Vitrectomy techniques with peeling of posterior hyaloid and ILM and internal tamponade with long acting gas or silicone oil, can eliminate traction exerted by the first 3 factors, but cannot prevent progression of posterior staphyloma. The aim of this work is to describe a new explant that could be easily assembled in the operating theater using 7 mm sponge strengthened with U-shape orthodontic stainless steel wire and reporting preliminary results of treating recurrent myopic macular hole RD following silicone oil removal.

Methods:

5 highly myopic eyes (axial length between 28:73 to 32:94 mm) with recurrent macular hole RD following silicone oil extraction underwent revision of vitrectomy, macular buckling using the above mentioned episcleral explant and long acting gas or silicone oil tamponade. Successful retinal reattachment with closure of the macular hole could be achieved in all 5 eyes. Although the buckling effect was not prominent, the new explant could reshape the posterior staphyloma.

Effectiveness / Safety:

This technique of macular buckling is effective in reshaping the posterior staphyloma, successful closure of myopic macular hole and achieving retinal reattachment following gas absorption and removal of silicone oil.

Take home message:

The preliminary results suggest that macular buckling, using the above mentioned explant may be considered for management of recurrent macular hole RD in highly myopic eyes, following silicone oil removal.