Internal limiting membrane removal for macular detachment in highly myopic eyes

PURPOSE: To present a treatment option for highly myopic eyes developing retinal detachment over a posterior staphyloma. DESIGN: Interventional case report. METHODS: Pars plana vitrectomy with peeling of the internal limiting membrane and gas tamponade; no laser retinopexy. RESULTS: Retinal reattachment with marked visual improvement. CONCLUSIONS: It appears that the rigid internal limiting membrane is responsible for the retina's inability to conform to the posterior staphyloma. Intraoperative findings suggest that this rigidity may also play a role in subsequent macular hole development. Internal limiting membrane removal should be considered in eyes with retinal detachment over a posterior staphyloma, whether or not a macular hole is present.