Journal article
Surgical Management and Outcomes of Large High Myopic Macular Holes: Global Macular Hole Multicenter Study 3
Retina (Philadelphia, Pa.)
05/05/2026
DOI: 10.1097/IAE.0000000000004871
PMID: 42085031
Abstract
To characterize the surgical management and outcomes of large high myopic macular holes (HMMHs).
Global multicenter retrospective case series of HMMHs with minimum linear diameter (MLD) ≥ 400 μm undergoing surgery between 2013-2023 with follow up ≥ 3 months. The main outcome measure was the HMMH closure rate at postoperative month 3.
499 cases of 463 patients from 37 surgeons were included, with mean ± SD age 58.3 ± 12.2 years, 77.0% female, 77.4% primary, 22.6% refractory, and mean ± SD follow-up 18.8 ± 20.2 months. The mean ± SD (range) MLD was 649 ± 280 (400, 2759) µm. Surgery techniques included 127 internal limiting membrane (ILM) peels, 285 ILM flaps, 19 amniotic membrane transplantations (AMT), 36 autologous retinal transplantations (ART), and 32 others. The postoperative month 3 closure rate for all cases was 72.4%. Closure rates significantly decreased with greater CLOSE Study Group size classification for HMMHs treated with ILM peeling or ILM flap (P = 0.006) but not for HMMHs treated with AMT or ART (P > 0.05). Visual acuity (VA) significantly increased from baseline to each follow-up time point among all eyes, with final mean ± SD change in VA of -0.29 (0.55) logMAR (+14.5 ETDRS letters), which did not significantly differ by surgery type.
HMMH closure rates are lower than those reported for macular holes in non-highly myopic eyes, but most eyes can still achieve anatomic closure and meaningful VA gains when treated with the appropriate technique.
Details
- Title: Subtitle
- Surgical Management and Outcomes of Large High Myopic Macular Holes: Global Macular Hole Multicenter Study 3
- Creators
- Tianyu Liu - Associated Retinal ConsultantsNassim A Abreu-Arbaje - Dominican HospitalJoana Andoh - Johns Hopkins HospitalJ Fernando Arevalo - Johns Hopkins HospitalRemzi Avci - Department of Ophthalmology, Retina Eye Hospital, Bursa, TurkeyBernardo Bach - University of Iowa, Ophthalmology and Visual SciencesMaria C Bohorquez - Instituto de Microcirugía OcularH Culver Boldt - University of IowaTimothy M Boyce - University of IowaAna L Carauni - Ospedale San PaoloMatteo M Carla - Instituto de Microcirugía OcularViet Q Chau - Associated Retinal ConsultantsHung-Da Chou - Chang Gung Memorial HospitalAdrienne Coche - Hôpital Maisonneuve-RosemontFrancesco M D'Alterio - Royal Liverpool University HospitalJason Fan - University of MiamiTina Felfeli - University of TorontoMariantonia Ferrara - University of BresciaMagno A Ferreira - Universidade Federal de UberlândiaCarolina Galvá Goriup - Dominican HospitalStratos Gotzaridis - Athens Eye HospitalNinel Z Gregori - University of MiamiAhmed M Habib - Ain Shams UniversityIan C Han - University of IowaYi-Ting Hsieh - National Taiwan University HospitalMakoto Inoue - Kyorin UniversityKazuaki Kadonosono - Yokohama City UniversityMotohiro Kamei - Aichi Medical UniversityLevent V Karabas - Kocaeli ÜniversitesiJacob Keeley - Oakland UniversityShohei Kitahata - Yokohama City UniversitySandeep Kumar - Dr. Shroff’s Charity Eye HospitalChi-Chun Lai - Linkou Chang Gung Memorial HospitalBingqian Liu - Sun Yat-sen UniversityLin Lu - Sun Yat-sen UniversityMohamed M Mahgoub - Ain Shams UniversityEfrem Mandelcorn - University of TorontoAhmed Mansour - Ain Shams UniversityCarlos Mateo - Instituto de Microcirugía OcularRyo Matoba - Okayama UniversityYuki Morizane - Okayama UniversityChristine Morozova - Retina Vitreous Associates Medical GroupZofia A Nawrocka - Niepubliczna Wyższa Szkoła MedycznaJerzy Nawrocki - Niepubliczna Wyższa Szkoła MedycznaMarcio B Nehemy - Universidade Federal de Minas GeraisRonaldo Nuesi - University of MiamiOgugua N Okonkwo - Smith-Kettlewell Eye Research InstituteEcem Onder Tokuc - Kocaeli ÜniversitesiSengul Ozdek - Gazi UniversityEce Ozdemir Zeydanli - Bilkent City Hospital, Ankara, TurkeyJong G Park - Retina InstituteBarbara Parolini - Eyecare Clinic, Brescia, ItalyFabio Patelli - Ospedale San PaoloSeemant Raizada - Kuwait Specialized Eye CenterRevati Rashingkar - Oakland UniversityEugen Reifschneider - Knappschaftsklinikum SaarFlavio A Rezende - Hôpital Maisonneuve-RosemontStanislao Rizzo - Università Cattolica del Sacro CuoreMario R Romano - Humanitas UniversityStephen R Russell - University of IowaKhalid A Sabti - Kuwait Specialized Eye CenterTeresa Sandinha - University of LiverpoolLydia Sauer - Associated Retinal ConsultantsAlfonso Savastano - LUM Jean Monnet UniversityDaraius Shroff - Dr. Shroff’s Charity Eye HospitalElliott H Sohn - University of IowaDavid H Steel - Sunderland Eye InfirmaryPeter Szurman - Knappschaftsklinikum SaarHomayoun Tabandeh - Retina Vitreous Associates Medical GroupJonathan Than - Guy's and St Thomas' NHS Foundation TrustLoka Thangamathesvaran - Johns Hopkins HospitalKotaro Tsuboi - Aichi Medical UniversityMei-Chi Tsui - National Taiwan University HospitalAna Rita Viana - Eyecare Clinic, Brescia, ItalyHannah Walsh - University of MiamiGeorge A Williams - Oakland UniversityTom H Williamson - Guy's and St Thomas' NHS Foundation TrustChen Xi - Sun Yat-sen UniversityChung-May Yang - National Taiwan University HospitalAysegul M Yildiz - Department of Ophthalmology, Retina Eye Hospital, Bursa, TurkeyTadashi Yokoi - Kyorin UniversityYoshihiro Yonekawa - Thomas Jefferson UniversityAndroniki Zampogianni - Athens Eye HospitalTamer H Mahmoud - Oakland University
- Resource Type
- Journal article
- Publication Details
- Retina (Philadelphia, Pa.)
- DOI
- 10.1097/IAE.0000000000004871
- PMID
- 42085031
- ISSN
- 0275-004X
- eISSN
- 1539-2864
- Language
- English
- Electronic publication date
- 05/05/2026
- Academic Unit
- Fraternal Order of Eagles Diabetes Research Center; Ophthalmology and Visual Sciences
- Record Identifier
- 9985161341402771
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