Vitrectomy for myopic traction maculopathy

Abstract

Objective: To describe the results of vitrectomy in highly myopic eyes affected by a form of posterior vitreous traction termed myopic traction maculopathy (MTM).

Methods: In this retrospective case series, 24 highly myopic eyes with MTM underwent vitrectomy and release of vitreoretinal traction without final fluid/gas exchange. Nine eyes (37.5%) received a combined phacovitrectomy. Mean patient age was 58 years, mean refractive error was -16.8 dioptric spherical equivalent, and preoperative visual acuity ranged from 20/400 to 20/32 (mean, 20/80). Mean follow-up was 29.6 months.

Results: Twenty-three (95.8%) of 24 eyes had complete and stable resolution of MTM after a mean of 4.4 months. Mean visual improvement was 2.5 Snellen lines (range, 0 to 6 lines). Five eyes (20.8%), despite achieving complete retinal flattening, developed a macular hole that did not progress to macular detachment during follow-up.

Conclusions: Vitrectomy without fluid/gas exchange leads to stable resolution of MTM and good visual improvement. Posterior retinal detachment probably precedes macular hole formation in highly myopic eyes.