Microincision vitrectomy surgery for myopic foveoschisis

Abstract

Objective: To evaluate the technical feasibility and surgical outcome of microincision vitrectomy surgery (MIVS) in patients with myopic foveoschisis (MF).

Methods: In total, 33 eyes of 29 patients who underwent surgical intervention due to MF were included. The patients were diagnosed with MF by spectral-domain optical coherence tomography (SD-OCT) and followed up for 6 months after MIVS that included internal limiting membrane (ILM) peeling with or without intraocular gas tamponade. To identify factors affecting visual outcome, the best-corrected visual acuity, axial length, and SD-OCT findings were analysed.

Results: After surgery, the mean BCVA improved from 1.01 ± 0.46 logMAR to 0.76 ± 0.64 logMAR (p=0.004). Central subfield thickness in SD-OCT decreased from 431 ± 256 μm to 231 ± 72 μm after surgery (p<0.001). SD-OCT showed complete resolution of MF with complete foveal reattachment in 96% of patients (27/28). The accompanying macular hole was successfully closed in all four cases. Hypotony <6 mm Hg was seen in one eye only. At the end of surgery, eight of 24 eyes (33.3%) undergoing 25-gauge MIVS and four of nine eyes (44.4%) undergoing 23-gauge MIVS required sutures to close at least one sclerotomy site. Postoperative development of a macular hole was seen in one patient. It was successfully treated by reoperation using silicone oil tamponade.

Conclusions: MIVS with ILM peeling appeared to yield favourable visual and anatomical outcomes for MF in highly myopic eyes.

Keywords: Macula; Retina; Treatment Surgery; Vision; Vitreous.