AIM:To evaluate the clinical effect of the auxiliary application of posterior scleral reinforcement(PSR)in the vitrectomy of macular hole retinal detachment with over-long axial length.

METHODS:A clinical randomized controlled trial was conducted. Patients of macular hole retinal detachment with over-long axial length ≥29mm were randomly divided into two groups. Group A accepted PSR + PPV + silicone oil injection, group B accepted PPV + silicone oil injection. After followed-up one year, the BCVA, the percentage of macular hole closure, cure rate of retinal detachment and reoperation rate were analyzed.

RESULTS:Totally 46 eyes were included in the study. The average BCVA of the two groups after treatment was improved. The BCVA of group A changed from 1.61±0.02 to 0.85±0.22(t=10.36, P<0.01), and that of group B increased from 1.59±0.04 to 1.08±0.16(t=7.92, P<0.01). The improvement of group A was greater than that of group B(t= -2.38, P=0.03). There was no significant change of the axial length before and after operation in both groups(P>0.05). In group A, the healing rate of macular hole was 91%(21/23), and the reoperation rate was 4%(1/23)before silicone oil removal. After silicone oil removal, no patients recurred to retinal detachment. During the follow-up period, silicone oil removal was completed in all eyes. In group B, the closure rate of macular hole was 65%(15/23), the rate of reoperation before silicone oil removal was 35%(8/23), the redetachment rate after silicone oil removal was 26%(6/23), and the rate of the silicone oil removal throughout the follow-up period was 74%(17/23).

CONCLUSION: PSR can effectively improve the successful rate of pathological myopic macular holes with retinal detachment and reduce the recurrence and reoperation.