Endophotocoagulation to retinal pigment epithelium as an adjuvant therapy in the management of retinal detachment caused by a highly myopic macular hole.

Retinal detachment secondary to a highly myopic macular hole remains a particular surgical challenge. Pars plana vitrectomy, endophotocoagulation at the base of a macular hole in conjunction with fluid-gas exchange was performed in 4 consecutive patients with a mean refraction of -13.8D (range, -8D-(-)18D). Mean axial length was 27.5 mm (range, 26.0-29.0 mm). Mild atrophy of the retinal pigment epithelium was present in 3 patients while 1 patient had moderate atrophy. The mean follow-up period was 12 months (range, 6-18 months). The overall primary anatomical success rate was 75%. All 3 eyes with mild retinal pigment epithelium atrophy had retinal reattachment after one operation.