A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

Abstract

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p < 0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p = 0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

Macular buckle with Morin–Devin T implant for pathological myopia with macular hole

“…In a previous study, a 25-g self-retaining chandelier endoilluminator along with a wide angle viewing system was used to confirm appropriate indentation. 13 In our case, we achieved satisfactory chorioretinal apposition and closure of MH though with abduction deficit at 3-month follow-up on SD-OCT. We believe that MTM with coexisting pathology can be addressed with scleral wall reshaping using a relatively simple technique of macular buckling with the Morin-Devin T implant.…”

“…12 Many case series with primary EMB or EMB with PPV have reported higher anatomical and functional success rate over primary PPV alone. [6][7][8][9][10][11][12][13] Different macular buckles have been described in the literature. The most popular one is the Ando plombe explant (Ondeko Corporation Japan).…”

Macular buckling versus vitrectomy on macular hole associated macular detachment in eyes with high myopia: a randomised trial

“…MB is a conventional surgical method for which various types of exoplants and techniques have been developed in recent years, such as the L-shaped and T-shaped silicone sponge that contains titanium, a silicone plate that contains a metal wire, the fibre optic light assisted MB technique and a sterile topical adhesive to fix the buckle. [15][16][17][18] Earlier studies that compared PPV with MB in eyes with highly myopic MHRD showed that MB yielded better anatomic and functional outcomes than PPV. 7 The surgical techniques PPV and ILM peeling were associated with a higher surgical failure rate.…”

<p>Combined Vitrectomy With Macular Buckling In High Myopic Eyes With Macular Hole Retinal Detachment: A Pilot Study Of A Novel Snail-Tipped Exoplant</p>

“…Transillumination of the exoplant under the fovea enables correct positioning of the exoplant. The surgical technique of MB is still progressing and Bedda et al14 suggested using sterile topical adhesive to fix the buckle under the fovea. This could prevent events of scleral perforation or bleeding due to suture placement.…”