Abstract
Purpose:
To describe the rationale and technique of pars plana vitrectomy (ppv) and fovea-sparing internal limiting membrane (ILM) removal for myopic traction maculopathy (MTM).
Methods:
Retrospective review of the clinical history and outcomes of highly myopic patients (> 26 mm axial length or < -6 diopters) with MTM and underwent PPV with fovea-sparing ILM peeling (MP).
Results:
Three eyes of 3 patients with visual loss from MTM underwent PPV with fovea-sparing ILM peeling. Preoperatively all eyes had optical coherence tomography (OCT) with retinoschisis and detachment. In all cases, the procedure included removal of a layer of cortical vitreous followed by ILM staining and peeling while preserving it in the central foveal area. At 3 months postoperatively all eyes achieved > 2 lines of visual acuity improvement and significant reduction of central foveal thickness on OCT. No patients developed a macular hole.
Conclusions:
After PPV/MP for MTM, there may be an increased risk for macular hole formation. The results from our case series supports the notion that fovea-sparing ILM peel may be a method to reduce the likelihood of macular hole formation while still resulting in improvement in vision and in in foveal anatomy.
Keywords: 585 macula/fovea •
586 macular holes •
605 myopia