Approach The Surgical Effect And Surgical Indication Of The Myopic Traction Maculopathy Primarily

Object:To approach the surgical effect and surgical indication of the Myopic Traction Maculopathy(MTM).Method:This retrospective case series included 31 eyes of 29 patients with MTM,2 patients of which were male and the other 27 patients were female.The cases were assigned to 2 groups according to the stage of MTM:(1)Group E(12 eyes),which included the eyes with the Early stage of MTM,that is to say the eyes with retinoschisis,with shallow retinal detachment without hole or with lamella macular hole; (2)Group A(19 eyes),which included the eyes with the Advanced stage of MTM,that is to say the eyes with macular hole accompanied by retinal detachment or not.All of these eyes underwent Standard 3-port Pars Plana Vitrectomy(PPV)combined with Triamcinolone Acetonide-assisted Internal Limiting Membrane Peeling(TA-ILMP). That whether iatrogenic retinal hole was happened in the surgeries was observed.The comparisons were taken between both groups,including the preoperative BCVA,the postoperative BCVA,the postoperative macular morphous and the reattachment of retina.Result:1.Preoperative BCVA:In Group E the LogMAR was 1.51±0.42;In Group A the LogMAR was 2.063±0.73.Significance was got between the two groups(P=0.038). 2.Complications in surgery:No iatrogenic retinal hole happened in all the surgeries.3.Postoperative BCVA:Refer to the distribution of the postoperative BCVA,significance was got between the two groups and Group E was better(P=0.005).In Group E,the postoperative BCVA was 0.84±0.27,thus indicating that the postoperative BCVA was better than the preoperative BCVA significantly(P=0.000).In Group A,the postoperative BCVA was 1.32±0.58,also indicating that the postoperative BCVA was better than the preoperative BCVA significantly(P=0.000).4.Vision acuity improvement after surgery:Group E got 100% (12/12),while Group A had 63.2%(12/19),so Group E was preferable with significance(P=0.000).5.Recovery of macular morphology after operation:The eyes with disappearance of the macular hole and without exposure of the pigment epithelium were 12 in Group E,but 3 in Group A;The eyes with defection of macular tissue but with retinal reattachment was none in Group E,while 13 in Group A;The eyes with macular hole and retinal detachment was none in Group E,but 3 in Group A.This expressed that the recovery of macular morphology in Group E was more significant than in Group A(P=0.000).6.Recovery of retinal morphology after operation:Group E had 12(12 in 12)with retinal reattachment,removing of traction and resorption of subretinal fluid,then Group A had 16 eyes(16 in 19)after surgery;Group E had 0(0 in 12)without retinal reattachment or without removing of traction or without resorption of subretinal fluid,then Group A had 3 eyes(3 in 19)after surgery.No significance was observed(P=0.154).Conclusion:1.PPV combined with TA-ILMP is an effective surgical treatment of MTM.2.The surgical indication of MTM should be earlier than the formation of macular hole and retinal detachment.3.ILMP with TA assisted is beneficial for the performance of the surgery and could reduce the development of some serious complications,such as iatrogenic retinal hole.