LAUSR

PURPOSE To evaluate efficacy of posterior scleral contraction (PSC) for macular hole with retinal detachment (MHRD) in high myopia. METHODS Seventy-three MHRD eyes were treated with PSC. A strip was sent across inferior-temporal scleral surface to posterior pole, then two ends were led out from nasal-inferior and temporal-superior areas. It was tightened to contract posterior sclera with designed axial length (AL) shortening ([10% of pre-operative AL-0.5]mm) after aqueous humors drained from anterior chamber. Recovery was classified as type I (retinal reattachment with MH bridged) and II (retinal reattachment without MH bridged). Follow-up duration was 25.3±18.0 months. RESULTS AL was 30.01±2.27mm at pre-operation and shortened by 2.57±0.82mm intra-operatively. At final post-operation, maintained AL shortening was 1.87±0.92mm. Forty-six eyes (63.0%) recovered as type I and 26 eyes (35.6%) as type II, 1 eye (1.4%) unrecovered. Post-operative best-corrected visual acuity (BCVA, logarithm of minimal angle of resolution [LogMAR]) was better than pre-operative one (0.85±0.50 [Snellen 20/125] vs. 1.11±0.56 [Snellen 20/250], P<0.001) with correlation (r=0.662, P<0.001) and consistency (Kappa=0.34, P<0.001) between two. BCVA improvement didn't differ between recovery types (P=0.206). CONCLUSION MHRD was successfully recovered by PSC with AL shortening. Visual improvement was achieved, correlated and consistent with pre-operative BCVA while independent of recovery types.