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Lin Lu, Bingqian Liu, Yonghao Li, Wei Ma, Xiling Yu; Macular Buckling Versus Vitrectomy for Myopic Macular Schisis and associated macular Detachment. Invest. Ophthalmol. Vis. Sci. 2018;59(9):869. doi: https://doi.org/.
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To compare the efficacy of macular buckling and vitrectomy on myopic macular schisis and associated macular detachment.
This is a prospective, randomized, open label, clinical trial. We randomly assigned highly myopic eyes showing macular schisis and macular detachment without full-thickness macular hole (FTMH) to surgical intervention of either macular buckling or vitrectomy. Macular buckling plus intravitreal C3F8 gas injection was performed in the buckling group. Small gauge vitrectomy, internal limiting membrane peeling, and C3F8 gas tamponade was performed in the vitrectomy group. Outcome measurements included FTMH development, best corrected visual acuity (BCVA) improvement, and surgical failure rate. Surgical adverse events were recorded.
A total of 85 eyes from 85 patients were assigned to one of the two groups. 80 patients were included, with 41 received buckling, and 39 eyes received vitrectomy. The mean age, refractive error, axial length, and baseline BCVA was not statistically different between the two groups. After surgery, the patients were followed for 12 months. FTMH development was observed in 11/39 (28.2%) eyes of vitrectomy group and no eye of buckling group (P<0.01). Seven eyes in vitrectomy group were determined as surgical failure due to FTMH development and macular detachment and required a second surgery. Subfoveal liquid sustained over 3 months was observed in 62.5% of buckling group and 41% of vitrectomy group. At 12 months, the mean improvement in BCVA (ETDRS) was greater in the buckling group (+20.4 letters) than in the vitrectomy group (+9.5 letters). Adverse events of buckling group included transient ocular pain (16/40), asymptomatic abduction limitation (19/41), metamophopsia (13/41), intraocular hemorrhage (3/41), implant exposure (2/41), esotropia (2/41). Cataract was observed in 11/39 eyes of vitrectomy group.
Macular buckling was more effective for myopic macular schisis and concurrent macular detachment, which achieved more visual improvement, meanwhile prevented vitrectomy related complications of FTMH and cataract development.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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