Session Title: Vitreoretinal Surgery I
Session Date/Time: Thursday 17/09/2015 | 08:30-10:30
Paper Time: 10:06
First Author: : J.Lemos PORTUGAL
Co Author(s): : R. Freitas C. Teixeira E. Conde R. Carvalho N. Gomes
PURPOSE:To present the surgical technique and report the visual and anatomical results of combined vitrectomy and macular buckling for patients with macular hole (MH) and foveoschisis related to high myopia.
Ophthalmology Department of Hospital Pedro Hispano, Ophthalmology Department of Hospital de Braga and OFTALCONDE - Clínica Oftalmológica, Portugal
Four highly myopic eyes (mean axial length of 30,86 mm, range from 30,20 mm to 31,91 mm) of four patients (3 women, 1 man, mean age 55,25 years, range from 39 to 70 years) presenting with posterior staphyloma, myopic foveoschisis and associated MH were evaluated. Preoperative OCT showed that all patients had foveoschisis, associated with full-thickness MH in 2 patients, full-thickness MH with retinal detachment in 1 patient and vitreomacular traction (VMT) in 1 patient. All patients underwent combined pars plana vitrectomy with internal limiting membrane peeling, gas tamponade and macular buckling. Main outcome measures were best-corrected visual acuity (BCVA) and anatomical outcome.
Combined vitrectomy and macular buckling resulted in MH closure/VMT resolution in 3 of the 4 patients. The patient with associated retinal detachment had a reattached retina but not MH closure. The mean preoperative BCVA was 1,01±0,86 logarithm of the minimum angle of resolution (logMAR) (range from 0,52 to 2,30 logMAR) and increased significantly to 0,51±0,53 logMAR (range from 0,22 to 1,30 logMAR) at the end of follow-up. Visual acuity improved in all 4 eyes. No intraoperative or postoperative complications were detected.
Combined vitrectomy and macular buckling is a safe and effective approach and results in good anatomical and visual outcomes in patients with macular hole associated with myopic foveoschisis.