Adjustable Macular Buckling for Full-Thickness Macular Hole With Foveoschisis in Highly Myopic Eyes

Cacciamani, Andrea; Lazzeri, Stefano; Rossi, Tommaso; Scarinci, Fabio; Parravano, Mariacristina; Ripandelli, Guido; Pileri, Marco; Nardi, Marco; Stirpe, Mario

doi:10.1097/iae.0000000000000802

Cited by 15 publications

(12 citation statements)

References 29 publications

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“…Macular buckling may be more suitable for overcoming the posterior bulging of the eyeball (Theodossiadis & Theodossiadis 2005). The surgical failure rate in the macular buckling group was much lower than in the vitrectomy group in our study, and this result is consistent with other studies (Parolini et al 2013(Parolini et al , 2015Cacciamani et al 2016;Wu et al 2017). Ando et al (2007) retrospectively analysed 58 highly myopic eyes that underwent macular buckling or PPV, and they found that the retinal reattachment rate was 93.3% after primary macular buckling and 50% after primary PPV.…”

Section: Discussionsupporting

confidence: 90%

Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Liu

Chen

et al. 2019

Acta Ophthalmologica

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Objective: To compare the efficacy and safety of macular buckling and vitrectomy for myopic traction maculopathy showing macular schisis (MS) and associated macular detachment (MD) but without full-thickness macular hole (FTMH). Design: Prospective, randomized, parallel, open-label study. Methods: Patients were randomly assigned to either buckling or vitrectomy group. Macular buckling and intravitreal C3F8 gas injection were performed in the buckling group. Small gauge vitrectomy, internal limiting membrane peeling (ILMP) and C3F8 gas tamponade were performed in the vitrectomy group. The patients were followed for 12 months. Main outcome measures: Best-corrected visual acuity (BCVA) at 12 months. Results: A total of 85 patients were randomized, 80 eyes were included (41 receiving buckling, 39 received vitrectomy), and 78 patients completed the study. There were less eyes determined as surgical failure and required a second surgery in the buckling group than vitrectomy the group (2.4% versus 18.4%, p = 0.021). After surgery, macular buckling achieved more improvement in BCVA (+21.7 versus +4.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, p = 0.002). FTMH development was observed in only 1 (2.4%) eye, after removing of the implant due to recurrent conjunctival erosion, in the buckling group and 10 (26.3%) eyes (seven with-, three without MD) in the vitrectomy group (p < 0.001). More eyes developed cataracts in the vitrectomy group than did in the buckling group (28.9% versus 7.5%, p = 0.014). Macular buckling-associated strabismus (esotropia), binocular diplopia and implant exposure were observed in limited cases. Conclusions and relevance: Macular buckling is superior to vitrectomy with ILM peeling plus gas injection for surgical treatment of MS and associated MD in high myopia.

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Section: Discussionsupporting

confidence: 90%

Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Liu

Chen

et al. 2019

Acta Ophthalmologica

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“…39 These poorer outcomes with pathologic myopia and foveoschisis have resulted in research into alternative treatment options such as an inverted ILM flap and macular buckling. 40,41 Neither of these were utilized in this study cohort. For personal use only.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Macular Hole Repair with Triamcinolone Acetonide Visualization

Wallsh¹,

Asahi²,

Gallemore³

2021

OPTH

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Purpose To evaluate the long-term anatomic and visual outcomes of macular hole (MH) repair utilizing triamcinolone acetonide (TA) visualization of the internal limiting membrane (ILM) treated at a tertiary care retina practice. Methods Retrospective chart review of eyes undergoing MH repair with ILM peel utilizing TA visualization followed by gas tamponade and facedown positioning between 2014 and 2020. Pre- and post-operative visual acuity (VA), IOP, and anatomic closure based on optical coherence tomography were documented. Results Seventy-eight eyes were followed for 2.3±0.2 years after primary repair with anatomic closure in 73 (94%) eyes at their final visit and excluding eyes with pathologic myopia, 97%, and for stage 2 and small MHs, 100%. In all eyes, VA significantly improved from 0.97±0.04 (Snellen: 20/187) to 0.66±0.06 (20/91) logMAR (p < 0.0001). There were 16 eyes with 4 years of follow-up, 10 (63%) eyes achieving a VA ≥20/30 at that follow-up visit. Stage 2 and 3 MHs had significantly greater improvements in VA than Stage 4 MHs, −0.46 ± 0.06 versus −0.11 ± 0.11 logMAR (p = 0.021). Of the 13 (17%) eyes with recurrent MHs, 6 (46%) had pathologic myopia and 8 (61.5%) had associated cystoid macular edema. Cataract progression was reported in 52 (96%) phakic eyes and 2 eyes required Ahmed valve placement for management of pre-existing glaucoma. Conclusion Long-term results of MH repair with TA for ILM visualization demonstrate that it is safe and effective. Visual acuity continued to improve throughout the follow-up. Pre-existing glaucoma may progress and recurrence is associated with pathologic myopia and macular edema.

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“…The anatomical outcome of the surgical intervention is measured by three main changes on OCT, namely, resolution of schisis, reattachment of fovea and macula, and closure of macular hole. [ 21 22 23 24 25 26 27 28 29 30 31 32 33 34 ] Of the three anatomical changes, most studies have noted success between 80% and 100% for foveal attachment (resorption of SRF) and resolution of schisis. [ 21 24 25 27 29 31 34 ] Closure of macular hole ranged between 60% and 80% in these studies.…”

Section: Current Utility Of Oct In Mb Surgery For Mtmmentioning

confidence: 99%

“…Visual fields and microperimetry tests would help in assessing the function by measuring the mean retinal sensitivity (MRS) increase and fixation stability along with best corrected visual acuity (BCVA). [ 33 ]…”

Section: Adjunctive Investigation For Mb Surgerymentioning

confidence: 99%

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Current concepts of macular buckle in myopic traction maculopathy

Susvar

Sood

2018

Indian J Ophthalmol

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Since its introduction by Charles L. Schepens, macular buckle (MB) surgery has evolved over the past 60 years. Optical coherence tomography (OCT) has given a paradigm shift to the understanding of myopic macula, thereby helping in objective evaluation of the various manifestation of traction maculopathy. Staphyloma evaluation by ultrasound, wide-field fundus photography, and MRI scans along with OCT has led to the resurgence of MB surgery in the treatment of myopic traction maculopathy (MTM). Various surgical techniques with different buckle materials are being performed with encouraging anatomical and functional success rates. This article reviews the literature to explain the current concept of MB surgery based on its evolution, different kinds of buckle materials, rationale for planning MB surgery, and different surgical techniques for the management of MTM.

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Adjustable Macular Buckling for Full-Thickness Macular Hole With Foveoschisis in Highly Myopic Eyes

Cited by 15 publications

References 29 publications

Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Long-Term Outcomes of Macular Hole Repair with Triamcinolone Acetonide Visualization

Current concepts of macular buckle in myopic traction maculopathy

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