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Ichibe et?al. (2003) studied 10 cases of macular hole with RD receiving vitrectomy with ILM peeling. They found a low macula hole closure rate (10%), and observed postoperative enlargement of the hole in seven cases. There may be a possible imbalance between the retina and the choroid�Csclera complex associated with elongated axial length and posterior http://www.selleck.cn/products/Cisplatin.html staphyloma in highly myopic eyes. In those cases that underwent vitrectomy, complex vitreoretinal adhesions were noted. Most had variable degrees of vitreous detachment. Even in cases with complete PVD, vitreoretinal attachment was noted far below the vitreous base. After gas injection, the vitreous fibre may be stretched around the gas bubble. This mechanism may explain the more extensive detachment when gas injection failed as the primary procedure. Another related complication is new break formation and detachment. Within 2?months after the procedure, two patients, one without PVD (case 1) and one with complete PVD (case 19), suffered from RRD with multiple peripheral breaks. Algvere et?al. (1988) treated 58 RRD patients with pneumatic retinopexy alone and found new breaks occurred in 12% of eyes and RD in previously uninvolved http://www.selleckchem.com/products/3-methyladenine.html quadrants was found in 24%. The incidence may be higher in highly myopic eyes because of complex vitreoretinal adhesion and the frequent presence of peripheral retinal degeneration. Apart from the increased severity of RD, other complications after gas injection were few. Five patients in this study had transient elevation of IOP that was easily controlled by medication. Only a few (35%) patients in our study achieved http://www.selleckchem.com/products/PD-0325901.html an improvement in VA after primary gas tamponade, whereas 50% had stable VA and 15% had worsened vision. Nearly all of our patients had VA?