Combination technique useful for treating myopic traction maculopathy
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NEW YORK — Scleral imbrication combined with pars plana vitrectomy and foveal-sparing internal limiting membrane peel can be an effective surgical option for the treatment of myopic traction maculopathy, leading to a high rate of success.
“Scleral imbrication has been previously described as a technique for macular hole retinal detachment associated with high myopia. In a study, we looked at using it in combination with pars plana vitrectomy (PPV) and foveal-sparing internal limiting membrane (ILM) peel as a surgical method for the treatment of myopic traction maculopathy (MTM),” Fong May Chew, FRCOphth, MBBS, BSc, said at the American Society of Retina Specialists annual meeting.
The primary outcome was to identify the anatomical success of this method, and secondary outcomes were best corrected visual acuity, axial length (AL) and postoperative refraction changes.
“Our method was a retrospective chart review. Case records of patients who underwent combined scleral imbrication, PPV and foveal-sparing ILM peel were analyzed. BCVA, AL, the resolution of myopic traction maculopathy and the shape of the posterior segment determined by OCT were evaluated,” Chew said.
Thirteen patients were included in the study. Mean preoperative BCVA was 0.97 logMAR, which improved to 1.16 logMAR postoperatively. Mean preoperative AL was 30.13 mm, which showed a significant decrease postop to 29.38 mm, with a mean decrease of –0.75 mm. The postoperative refraction shifted by +0.25 D of spherical equivalent. The percentage of successful macular attachment was 71.4%, with one patient lost to follow-up.
“In conclusion, our results showed a good rate of success for this combined technique in eyes with MTM,” Chew said. “Further studies with larger sample size are needed to confirm these outcomes.”
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Chew FM, et al. Scleral imbrication with combined pars plana vitrectomy and foveal sparing ILM peel as a useful surgical modality in treating myopic traction maculopathy. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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