Macular buckling technique in high myopia: The state of the art

Session Details

Session Title: Free Paper Session 1: Vitreoretinal Surgery I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:18

Venue: Room 111

First Author: : M.Alkabes ITALY

Co Author(s): :    C. Mateo                             

Abstract Details

Purpose:

To clarify the state of the art on anatomical and functional outcomes after macular buckling (MB) in high myopia.

Setting:

In the last 15 years, the macular buckling (MB) has started to regain ground as an effective surgical procedure to treat severe vitreoretinal conditions in high myopic patients.

Methods:

Based on the PubMed database, all published articles on MB in high myopia from 2000 to 2016 were reviewed. Main outcomes included retinal reattachment and macular hole (MH) closure rates, resolution of the myopic foveoschisis (MFS) and postoperative visual acuity.

Results:

Thirty-one articles were published and 489 high myopic eyes were treated with MB technique. Sixteen studies included patients affected by retinal detachment due to a macular hole (MHRD Group, 272 eyes), eleven by MFS with or without FD (MFS Group, 178 eyes) and four by MH with MFS (MH-MFS Group, 39 eyes). Surgical techniques mostly differed on the type of buckle, rectus muscles involvement and concomitant PPV. In the MHRD Group, retinal reattachment and MH closure rates range from 81.8% to 100% and from 40% to 100%, respectively. A second surgery was required in 2.9% of patients and unsuccessful PPV had been previously applied in 27.5% of cases. Contrarily to PPV, eyes with unclosed MH after MB did not showed an increased risk of retinal redetachment. In the MH-MFS Group, both MFS resolution and MH closure were achieved in 100% of cases. In the MSF Group, secondary MHs were more likely to develop in case of PPV and ILM peeling rather than with MB, even when combined with PPV. Overall, the most common complications were RPE disturbance (>2.4%), MB removal (2%) or malpositioning (1.8%) and choroidal effusion (1.4%). Scleral perforation was described in 7 out of 489 cases (1.4%).

Conclusions:

Despite different approaches, MB is a safe and effective technique which provides complete resolution of the foveoschisis, retinal reattachment and concomitant MH closure in high myopic eyes. Moreover, all these results seem to be achieved more frequently with MB than PPV.

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