Surgical outcomes of macular buckling techniques for macular retinoschisis in highly myopic eyes

Abstract

Purpose: To report the anatomic and visual results following macular buckling for patients with macular retinoschisis related to high myopia.

Methods: Thirty-nine highly myopic eyes (mean refractive error -16.7 D; range, -9 to -24 D) of 36 patients (mean age 59 years; range, 35-79 years) presenting with macular retinoschisis associated with a posterior staphyloma, who underwent combined vitrectomy and macular buckling were evaluated. Main outcome measures included best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings. Three cases were excluded due to short follow-up (less than 3 months). The mean follow-up was 16 months.

Results: The mean BCVA increased from 0.76 to 0.43 LogMAR (p = 0.001). Visual acuity improved in 30 eyes (83.3%), remained stable in three eyes (8.3%) and decreased in three eyes (8.3%). OCT showed resolution of foveoschisis with foveal reattachment in all eyes. None of the evaluated patients developed a macular hole during follow-up.

Conclusion: Macular buckling associated with vitrectomy results in good anatomic and visual outcomes in patients with myopic foveoschisis.

Keywords: High myopia; Lamellar macular hole; Macular buckling; Macular detachment; Myopic foveoschisis; Optical coherence tomography; Pars plana vitrectomy; Posterior staphyloma; Retinoschisis.

Figure 1

Comparison of preoperative best corrected visual acuity (BCVA) and postoperative BCVA in logarithm of the minimal angle of resolution (LogMAR) units for 36 eyes. The improvement in BCVA was statistically significant (p < 0.05; paired t-test).

Figure 2

Comparison between mean pre- and postoperative best-corrected visual acuity (LogMAR) in relation to preoperative OCT findings (MS, macular schisis; FD, foveal detachment; LMH, lamellar macular hole).

Figure 3

Preoperative and postoperative OCT scans.