Foveoschisis after vitrectomy for myopic macular hole with secondary retinal detachment

Abstract

Sir, Foveoschisis after vitrectomy for myopic macular hole with secondary retinal detachment Macular foveoschisis is a recently identified cause for visual loss in pathological myopia. 1 Factors contributing to foveal splitting include vitreoretinal traction, chorioretinal atrophy, axial elongation, and recently, arteriolar traction. 2,3 We report a foveoschisis that occurred many years after surgery for retinal detachment (RD) associated with a myopic macular hole. Case reportA 49-year-old lady presented to us with decreased vision OS for 2 months. Best-corrected visual acuities (BCVAs) were 6/12 (À11 þ À2 Â 90) OD and hand motions

Macular Buckling for Eyes With Myopic Foveoschisis Secondary to Posterior Staphyloma

“…In spite of the good results achieved with vitrectomy and ILM peeling in experienced hands, this surgical approach fails in some cases. 8,22 It should also be mentioned that ILM peeling in highly myopic eyes is difficult and may result in complications. Besides from the possibility of recurrence, other complications after vitrectomy for MF have been reported, such as MH formation 14 or enlargement of a previously small MH.…”

“…Vitrectomy combined with ILM peeling seems to show better results as seen in various small pilot studies, [16][17][18][19] although recurrence of MF after vitrectomy with ILM peeling has been previously reported. 8 Reshaping the posterior scleral wall by means of macular buckling corrects the disproportion between the retina and the elongated sclera and seems a reasonable surgical approach to treat MF. 20 In addition, macular buckling brings the RPE closer to the retina, reinforcing the already weak adherence between the RPE and the neurosensory retina because of the severe myopic chorioretinal atrophy.…”

Three‐year outcomes of macular buckling for macular holes and foveoschisis in highly myopic eyes

“…Postoperative nonclosure or reopening of the hole, as well as retinal redetachment, may still occur despite interventions, while in some cases, achieving anatomical success may require multiple procedures. When used as the sole treatment modality, vitrectomy can release tangential and centrifugal traction caused by vitreous cortex (Shukla & Dhawan ), although it leaves the posterior staphyloma untreated (Nakanishi et al. ; Nadal et al.…”

<p>Combined Vitrectomy With Macular Buckling In High Myopic Eyes With Macular Hole Retinal Detachment: A Pilot Study Of A Novel Snail-Tipped Exoplant</p>

“…Since 1982, when Gonvers and Machemer first introduced pars plana vitrectomy (PPV) for the treatment of MHRD,4 PPV with or without ILM peeling and gas tamponade has become the treatment of choice for MH or MHRD surgery. PPV releases tangential and centripetal traction caused by the vitreous cortex,5 but there still exists vascular traction and anteroposterior traction caused by the PS that stretches the retina. Although macular buckling (MB) was first reported in 1957,6 which was the only method of treatment for MHRD for over 20 years before the era of PPV, it was not a popular surgical procedure because of its surgical difficulties and increased risk of surgical complications.…”