Microincision vitrectomy surgery for myopic foveoschisis.

Abstract

To evaluate the technical feasibility and surgical outcome of microincision vitrectomy surgery (MIVS) in patients with myopic foveoschisis (MF). In total, 33 eyes of 29 patients who underwent surgical intervention due to MF were included. The patients were diagnosed with MF by spectral-domain optical coherence tomography (SD-OCT) and followed up for 6 months after MIVS that included internal limiting membrane (ILM) peeling with or without intraocular gas tamponade. To identify factors affecting visual outcome, the best-corrected visual acuity, axial length, and SD-OCT findings were analysed. After surgery, the mean BCVA improved from 1.01 ± 0.46 logMAR to 0.76 ± 0.64 logMAR (p=0.004). Central subfield thickness in SD-OCT decreased from 431 ± 256 μm to 231 ± 72 μm after surgery (p<0.001). SD-OCT showed complete resolution of MF with complete foveal reattachment in 96% of patients (27/28). The accompanying macular hole was successfully closed in all four cases. Hypotony <6 mm Hg was seen in one eye only. At the end of surgery, eight of 24 eyes (33.3%) undergoing 25-gauge MIVS and four of nine eyes (44.4%) undergoing 23-gauge MIVS required sutures to close at least one sclerotomy site. Postoperative development of a macular hole was seen in one patient. It was successfully treated by reoperation using silicone oil tamponade. MIVS with ILM peeling appeared to yield favourable visual and anatomical outcomes for MF in highly myopic eyes.