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Takuya Nakajima, Miyuki Nagahara; Evaluation of Clinical Outcomes of Scleral Imbrication Combined with Vitrectomy for Myopic Traction Maculopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4747.
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© ARVO (1962-2015); The Authors (2016-present)
Myopic traction maculopathy, such as macular hole (MH), lamellar macular hole (LMH), macular hole retinal detachment (MHRD) and foveoschisis, is hard to treat and difficult to be morphologically improved. We performed a retrospective analysis of medical records to evaluate clinical outcomes of scleral imbrication combined with vitrectomy for myopic traction maculopathy.
Medical records of 6 eyes of 6 cases with myopic traction maculopathy who underwent scleral imbrication combined with 23G or 25G pars plana vitrectomy from 2016 to 2017 in the Tokai University Hachioji Hospital were retrospectively reviewed. 6 eyes comprised 1 LMH, 3 MH with or without foveoschisis, and 2 MHRD. Surgical procedures included temporal lamellar scleral dissection by 7×14mm, plicating and suturing lamellar-dissected sclera with 6-0 Vicryl® (ETHICON) to shorten the eye axial length and 20% SF6 gas exchange. Clinical parameters were evaluated by best corrected visual acuity (BCVA), intraocular pressure (IOP), refractive cylinder power, posterior segment distance measurement by optical coherent tomography (OCT), and complications at 1 month, 3 months and 6 months after surgery. A comparison between the parameters before and after surgery was analyzed with the Wilcoxon signed-rank test.
The mean age (years old) was 69.5±14.9 (mean±SD) ranged from 49 to 86. The mean follow-up period (months) was 4.3 months. The mean BCVA (logMAR) was 0.96±0.51 before surgery and improved to 0.75±0.33 after surgery. The posterior segment distance was shortened by 9.5±17.6 (%) (p<0.01). IOP (mmHg) showed no significant difference before and after surgery. The mean refractive cylinder power (D) was deteriorated from -1.3±1.4 to -5.58±1.27 at 1 month, whereas it improved to -1.63±1.8 at 3 months. All eyes were improved in morphology according to OCT, that is, MHs were closed, MHRDs showed reattachment and LMH developed better alignment. There were no severe complications while follow-up.
Scleral imbrication combined with vitrectomy obtained good results in treatment for myopic traction maculopathy.
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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