<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>

Abstract

PurposeTo evaluate the efficacy of a novel snail-tipped exoplant for macular buckling combined with vitrectomy in high myopic eyes with macular hole retinal detachment.Patient and methodsA novel exoplant was simply prepared with a 5 × 3 mm silicone sponge strengthened in the center with a malleable titanium plate. One end was bent to make a rolled tip like a snail shell to be placed under the macula. Combined vitrectomy with macular buckling using this exoplant was performed in eight consecutive cases. The long arm of the exoplant was manipulated manually to fit the curvature of the eyeball and the length was trimmed appropriately after scleral suturing of the exoplant.ResultsRetinal reattachment was achieved in all cases (100%) and macular hole closure was confirmed in 6 eyes (75%). The mean best-corrected visual acuity improved from 1.53 ± 0.73 LogMAR preoperatively to 1.14 ± 0.59 LogMAR to postoperatively (p = 0.063). The mean pre- and postoperative AL was 28.44 ± 1.86 mm and 27.60 ± 1.83 mm, respectively (p = 0.016). The mean follow-up period was 15.4 months and no buckle-related complications such as diplopia, infection or exposure of the exoplant were noticed during the period.ConclusionThis exoplant could easily be prepared with readily available materials in the operating room and it was well tolerated with favorable anatomic results in high myopic eyes. Further studies of increased number of patients with long-term follow-up will be necessary.

Macular Buckling Combined With Vitrectomy and Inverted Internal Limiting Membrane Flap Technique for Macular Holes With Macular Retinoschisis Without Retinal Detachment in High Myopia

“…8,9 Given the fact that diverse tractions induced by varied vitreoretinal interface abnormalities may remain without PPV, it is reasonable to combine macular buckling with PPV. 10,11 Still a subset of FTMHs did not respond to macular buckling along with PPV and ILM peeling, with a reported FTMH closure rate of 60%-82%. [11][12][13] To promote the anatomical success rate, the inverted ILM flap technique had been reported as an option.…”

“…10,11 Still a subset of FTMHs did not respond to macular buckling along with PPV and ILM peeling, with a reported FTMH closure rate of 60%-82%. [11][12][13] To promote the anatomical success rate, the inverted ILM flap technique had been reported as an option. 14 In this article, we reported on our results of using macular buckling alone and the combination of macular buckling and PPV with the inverted ILM flap technique to treat highly myopic FTMH with concurrent MRS.…”

“…10,11 Still a subset of FTMHs did not respond to macular buckling along with PPV and ILM peeling, with a reported FTMH closure rate of 60%-82%. 11–13 To promote the anatomical success rate, the inverted ILM flap technique had been reported as an option. 14…”