Surgical and clinical outcomes for high myopic foveoschisis: Beyond the anatomical success

Session Details

Session Title: Free Paper Session 28: Vitreoretinal Surgery VII

Session Date/Time: Sunday 10/09/2017 | 12:00-13:30

Paper Time: 13:18

Venue: Room 116

First Author: : I.Astorga Carballo MEXICO

Co Author(s): :    J. Rodriguez-Loaiza                             

Abstract Details

Purpose:

To evaluate the surgical and clinical outcomes of patients with high myopia foveoschisis

Setting:

Fundación de Asistencia Privada; Instituto de Oftalmología Conde de Valenciana, located at Mexico City.

Methods:

Retrospective, comparative, interventional case series. In this retrospective clinical study we evaluated 8 eyes of 8 patients that underwent surgical treatment for myopic foveoschisis confirmed by optical coherence tomography (OCT) and visual loss associated with metamorphopsia between March 1, 2016 and March 1 2017 with a follow up of at least 6 months. Three eyes (37.5%) went through vitrectomy and internal limiting membrane (ILM) peeling , five eyes (62.5%) were treated with vitrectomy and induction of posterior vitreous detachment (IPVD). From the total of the eyes (patients), 7 were left with gas tamponade and one eye with air in vitreous cavity . Of the three eyes that underwent vitrectomy and ILM peeling , gas tamponade was performed with 18% sulfur hexafluoride (SF6) in 2 eyes and with 14% perfluoropropane (C3F8) in one eye (patient). From the eyes that went throught vitrectomy and IPVD, C3F8 was performed in 3 eyes and SF6 was performed in 2 eyes. For the one patient that was not treated with gas tamponade a vitrectomy with IPVD was made. All patients underwent a complete ophthalmological examination, including best-corrected visual acuity (BVCA) and fundoscopy slit-lamp biomicroscopy. OCT was performed before and after surgery.

Results:

Mean refraction was -9.50 diopters and mean axial lengh was 28.75 mm. After surgery the OCT showed resolution of foveoschisis in 6 (75%) eyes that mantained through the follow up , one of them was the no gas tamponade treated and the other one was one of the SF6 tamponade group, showing in these patients a significant decrease in the neuro-sensorial retina-EPR space (anatomial improvement) Mean BVCA improved from 1.8 to 1.3 logMAR (1.8-0.6 logMAR).

Conclusions:

Vitrectomy with IPVD and vitrectomy with ILM showed the same effectivity between them in a long-term follow up , nervertheless the effectivity of the surgery in the resolution of the foveoschisis presented a decrease when it was used no tamponade or a short-term transient gas tamponade as it is the SF6. The BVCA showed a significant improvement after the surgery, particularly in patients which an OCT that showed the ellipsoid layer conserved, which is a prognostic factor.

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