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Francesco Boscia, Daniele Cardillo, Ermete Giancipoli, Francesco Blasetti, Giuseppe D'Amico Ricci; Twenty-Five Gauge Vitrectomy for Myopic Foveoschisis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5090.
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© ARVO (1962-2015); The Authors (2016-present)
To report the surgical outcomes of 25-gauge vitrectomy with internal limiting membrane (ILM) peeling in eyes with myopic foveoschisis (MF).
The medical records of 25 eyes of 20 patients that had undergone 25-gauge vitrectomy with ILM peeling for MF were studied. The main outcome measures were the best-corrected visual acuity (BCVA) and the optical coherence tomography (spectral domain OCT) findings. The eyes were divided into 2 groups: 1) Foveal-detachment group (FD group) and 2) Non Foveal detachment group (no-FD group)
On OCT, five eyes had a foveal detachment (FD), and 20 eyes did not show a foveal detachment. Thirteen eyes underwent phacoemulsification + IOL implantations combined with PPV. After a mean follow up of 7 weeks (± 3,71), final mean BCVA improved from the preoperative values in the FD group from (mean +/- Standard deviations) 1.0±0.57 logarithm of the minimum angle of resolution [logMAR] units to 0.61±0.58 logMAR units; P=0.15). In the no-FD group, the BCVA improvement was significant, from 0.60±0.35 logMAR units to 0.26±0.23 logMAR units; P=< 0.005. Pre and post operative spherical equivalent were respectively: -8.68 ± 7.5 and -2,69 ± 4.53. Postoperative OCT images showed a resolution of the MF with a non significative reduction in the central foveal thickness from the preoperative values in the FD group (542±250µ to 313±149µ; P=0.08, mean ± standard deviation) and in a significant way in the no-FD group (417±103µ to 293±54µ; P=0.0002). Anatomical improvement (CRT reductions) or stability were achieved in 24 eyes (96%). A preexisting outer layer defect was correlated to a poorer improvement in BCVA. No significative postoperative complication was reported.
Twenty five-gauge vitrectomy and ILM peeling for MF results in favorable visual and anatomic outcomes. We recommend that 25-gauge vitrectomy be used to treat eyes with MF.
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