Surgical treatment of macular hole in myopia

Objective: evaluate the time of occurrence of macular holes and the results of surgical treatment in patients with myopia of varying degrees. Material and methods. 47 patients, 47 eyes with stage 3 and 4 macular holes were examined. Group 1 included 18 eyes with high myopia and eye length from 27.0 mm or more, group 2 included 17 patients with moderate myopia and eye length from 25.0 to 26.99 mm, group 3 (comparison) included 12 patients (12 eyes) with macular holes in mild myopia and emmetropia. Visual acuity in group 1 before treatment with maximum correction was 0.05±0.02, in group 2 it was 0.07±0.02, in group 3 it was 0.08±0.04. All patients underwent subtotal vitrectomy with removal of the posterior hyaloid membrane, peeling of the internal limiting membrane, closure of the rupture with platelet mass, and gas tamponade. Results. The average age of onset of macular hole in group 1 was 51 1±3.2 years, in group 2 - 57.1±2.4 years, in group 3 - 65.2±3.8 years. Closure of the gap was noted in 100% in group 1, in group 2 also in 100%, in group 3 in 83.3%. Visual acuity in group 1 after surgery increased to 0.1±0.05, in group 2 - up to 0.4±0.02, in group 3 - 0.5±0.05. Conclusion. Myopic refraction is a risk factor for the formation of a macular hole at an earlier age. Vitrectomy eliminates the traction effect on the macula during epiretinal membrane and closes the macular hole, while there is a stable increase in visual acuity for 6 months. Macular holes in high myopia require immediate surgical treatment as they lead to retinal detachment.