Purpose  To study the anatomical outcomes of pars plana vitrectomy (PPV) with or without Triamcinolone acetonide (TA) -- assisted and internal limiting membrane (ILM) peeling in the treatment of highly myopic retinal detachment caused by macular hole (MHRD).

Methods  A retrospective clinical trial included 88 highly myopic eyes with MHRD. Comparing the rates of retinal reattachment and macular hole closure in ILM-peeled or ILM-preserved eyes that underwent PPV with TA -- assisted or not at 12 months after surgery.

Results  There were no differences of the macular hole closure and retinal reattachment rates in ILM-peeled eyes without TA -- assisted PPV compared with ILM-preserved eyes with TA -- assisted PPV. The macular hole closure rate was lower in ILM-preserved eyes without TA -- assisted PPV compared with ILM-peeled eyes or ILM-preserved eyes with TA -- assisted PPV. There was higher success rate in MHRD with “short” axial length (< 29.0 mm), “mild” extent of chorioretinal atrophic and posterior staphyloma.
Conclusions  There were higher success rates in both TA -- assisted PPV and PPV with ILM peeling in the treatment of MHRD, especially in those with “short” axial length, “mild” extent of chorioretinal atrophic and posterior staphyloma.