Primary silicone oil tamponade and internal limiting membrane peeling for retinal detachment due to macular hole in highly myopic eyes with chorioretinal atrophy

BACKGROUND Retinal detachment (RD) secondary to macular hole (MH) is a common complication in highly myopic eyes, usually leading to a poor visual prognosis. The purpose of this study was to evaluate the surgical outcome of silicone oil (SO) tamponade and internal limiting membrane (ILM) peeling in the treatment of RD caused by MH (MHRD) in highly myopic eyes with chorioretinal atrophy, and to identify clinical factors associated with the anatomical outcomes. METHODS We retrospectively reviewed 21 eyes of 21 highly myopic patients affected by RD secondary to MH and chorioretinal atrophy. All eyes were treated with pars plana vitrectomy (PPV) with ILM peeling and SO tamponade. Anatomical success was defined as reattachment of the retina with the closure of the MH, as assessed by optical coherence tomography (OCT), after SO removal. Logistic regression was performed to determine the clinical factors influencing anatomical success. RESULTS The mean patient age was 59.95 years [standard deviation (SD), 10.39; range, 34-77 years] and the mean axial length was 30.58 mm (SD, 1.52; range, 27.99-34.51 mm). After the first surgical procedure, the anatomical success rate was 61.9% (13 eyes in 21 eyes), with initial retinal attachment of 16 eyes (76.2%). A second surgical approach was performed for the five eyes with persistent or recurrent RD, and the final retinal reattachment rate was 100% (21/21). Logistic regression analysis showed that no specific factors were significantly associated with anatomical success. CONCLUSIONS Primary silicone oil tamponade and ILM peeling can be a practical treatment for repairing MHRD in highly myopic eyes with chorioretinal atrophy.