The Efficacy Of Macular Buckle For Myopic Macular Retinoschisis With Posterior Staphyloma

ObjectiveAt present,they are controversial on the surgical methods of myopic macular retinoschisis(MRS)with posterior staphyloma(PS).To explore the efficacy of macular buckle for MRS with PS,a group of cases of macular buckle were analyzed retrospectively in order to find a better choice for MRS with PS and provide evidence for clinical strategy.MethodsThe clinical data of 30 eyes of 27 consecutive patients of MRS with PS who were treated with macular buckle from May 2017 to Jun.2019 in Henan Provincial Eye Hospital were analyzed retrospectively.The best corrected visual acuity(BCVA),diopters,intraocular pressure(IOP),fundus color photography,axial length(AL),B ultrasound scanner,three-dimensional magnetic resonance imaging(3D-MRI)and optical coherence tomography(OCT)and complications were examined before and after surgery.The followed-up time was more than 6 months after surgery.The visual acuity,image changes,the central macular thickness(CMT)and complications were observed.Wilcoxon matched-pairs signed-ranks test were used to evaluate BCVA and diopters between preoperation and postoperation.Results1.27 consecutive patients(30 eyes)including 9 males(10 eyes)and 18 females(20 eyes)who underwent macular buckle were enrolled and retrospectively reviewed in this study.The ages ranging from 28 to 77 years with an mean age(51.3 ± 12.48)years.Preoperative mean diopter was(-14.93±5.73)D,preoperative median AL was 29.43(27.99,30.57)mm and preoperative median BCVA(logMAR)was 1.25(0.80,1.30).z2.The BCVA was improved in 6 eyes(20.0%),stable in 22 eyes(73.3%),and decreased in 2 eyes(6.67%)six months after the operation.The BCVA(logMAR)was improved from 1.25(0.80,1-30)preoperatively to 1.00(0.575,1.30)postoperatively(P=0.046).3.According to the morphology of fundus photography,OCT and 3D-MRI of the eyes,all PS types were macular staphyloma and the types of MRS in all eyes were divided into macular retinoschisis(RS)(46.7%)and macular retinoschisis with foveal detachment(FD)(53.3%).At 6 months after surgery,OCT examination showed complete retinoschisis resolution in 8 eyes(26.7%),partial resolution in 17 eyes(56.7%),slightly changed in 5 eyes(16.7%).The reattachment of FD was usually observed 1 day after operation,and 3 eyes were respectively 14 days,30 days and 90 days after operation.4.All patients completed the operations successfully without intraoperative complications such as eye penetrating injury,vortex vein injury and so on.Besides,no serious postoperative complications such as macular hole and endophthalmitis occurred in all eyes.The postoperative complications were high intraocular pressure in 1 eye(3.3%),retinal hemorrhage in 2 eyes(6.7%),diplopia in 2 eyes(6.7%)and metamorphopsia in 5 eyes(16.7%).High intraocular pressure was relieved for 2 days,retinal hemorrhage was absorbed by itself in 1 week and the symptoms of diplopia and metamorphopsia were relieved by themselves for two months.ConclusionMacular buckle can effectively reduce the central macular thickness of myopic macular retinoschisis with posterior staphyloma and improve visual acuity,but surgical risks should be considered.