Macular Buckling Using a Three-Armed Silicone Capsule for Foveoschisis Associated With High Myopia

Liu, Bingqian; Ma, Wei; Li, Yonghao; Luo, Yan; Jin, Chenjin; Liang, Xiaoling; Sadda, Srinivas R; Gao, Qianying; Lü, Lin

doi:10.1097/iae.0000000000001014

Cited by 20 publications

(14 citation statements)

References 32 publications

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“…Parolini et al (2015) found that combined vitrectomy and buckling took more surgical time and led to more complications and therefore suggested that macular buckling alone should be the first choice for MTM. Our previous study using a three-armed adjustable silicon capsule in highly myopic eyes with foveoschisis and found that none of the eight patients enrolled in the study required secondary surgery during the follow-up time of about 1 year (Liu et al 2016). In the present study, the need for a second surgery in the buckling group was only one of the 40 enrolled patients (2.5%).…”

Section: Discussioncontrasting

confidence: 40%

“…A retrospective trial demonstrated that there was limited BCVA improvement in the vitrectomy group but that there was significantly increased BCVA in the macular buckling group in highly myopic eyes with retinal detachment and FTMH (Ripandelli et al 2001). Our previous study found that macular buckling significantly improved the BCVA followed for about 1 year (Liu et al 2016). In the present study, in the buckling group, the BCVA improved by about 21 letters; in the vitrectomy group, the mean improvement of BCVA was about four letters, partially because there were more patients in which MD and FTMH occurred and more patients who developed mild to severe cataracts, which cause worsened BCVA.…”

Section: Discussionmentioning

confidence: 96%

“…Macular buckling can relieve the traction of the posterior staphyloma and result in anatomic improvement and visual elevation (Bur es-Jelstrup et al 2014;Zhu et al 2016;Wu et al 2017) In our previous study, we found macular buckling as primary procedure could improve anatomic disorder and visual decrease caused by MMS (Liu et al 2016). Recent comparative studies have shown that macular buckling achieved better visual improvement and anatomic recovery than vitrectomy in highly myopic eyes with macular hole-related retinal detachment (Ripandelli et al 2001;Ando et al 2007;Parolini et al 2013;Alkabes et al 2014).…”

Section: Introductionmentioning

confidence: 94%

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Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Liu

Chen

et al. 2019

Acta Ophthalmologica

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Objective: To compare the efficacy and safety of macular buckling and vitrectomy for myopic traction maculopathy showing macular schisis (MS) and associated macular detachment (MD) but without full-thickness macular hole (FTMH). Design: Prospective, randomized, parallel, open-label study. Methods: Patients were randomly assigned to either buckling or vitrectomy group. Macular buckling and intravitreal C3F8 gas injection were performed in the buckling group. Small gauge vitrectomy, internal limiting membrane peeling (ILMP) and C3F8 gas tamponade were performed in the vitrectomy group. The patients were followed for 12 months. Main outcome measures: Best-corrected visual acuity (BCVA) at 12 months. Results: A total of 85 patients were randomized, 80 eyes were included (41 receiving buckling, 39 received vitrectomy), and 78 patients completed the study. There were less eyes determined as surgical failure and required a second surgery in the buckling group than vitrectomy the group (2.4% versus 18.4%, p = 0.021). After surgery, macular buckling achieved more improvement in BCVA (+21.7 versus +4.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, p = 0.002). FTMH development was observed in only 1 (2.4%) eye, after removing of the implant due to recurrent conjunctival erosion, in the buckling group and 10 (26.3%) eyes (seven with-, three without MD) in the vitrectomy group (p < 0.001). More eyes developed cataracts in the vitrectomy group than did in the buckling group (28.9% versus 7.5%, p = 0.014). Macular buckling-associated strabismus (esotropia), binocular diplopia and implant exposure were observed in limited cases. Conclusions and relevance: Macular buckling is superior to vitrectomy with ILM peeling plus gas injection for surgical treatment of MS and associated MD in high myopia.

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Section: Discussioncontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 94%

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Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Liu

Chen

et al. 2019

Acta Ophthalmologica

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“…19,20 The use of a scleral buckle to reduce the tractions secondary to staphyloma has been reported with good anatomical and functional results. [21][22][23][24] Recent studies have shown that macular buckles are safe and well tolerated, even after long-term follow-up, and have a very low rate of complications. Therefore, the authors suggested that macular buckles should be used alone as the first intervention, whereas vitrectomy should be used in combination with a macular buckle or as a second-line approach in MTM eyes.…”

Section: Discussionmentioning

confidence: 99%

Morphological analysis and quantitative evaluation of myopic maculopathy by three-dimensional magnetic resonance imaging

Liu

et al. 2018

Eye

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PurposeTo study the characteristic morphology and quantitatively evaluate the eye shape in different types of myopic maculopathy.MethodsA total of 103 eyes from 65 patients with high myopic maculopathy were examined by spectral-domain optical coherence tomography (SD-OCT) and three-dimensional magnetic resonance imaging (3D MRI). The participants were classified into two groups, namely myopic traction maculopathy (MTM) eyes and non-MTM eyes, with SD-OCT imaging. Volume renderings and morphology analysis of the 3D MRI of the eyeball were obtained. Quantitative analysis was achieved in the calculation of vitreous volume and the three-dimensional diameters of the eyeball in three cardinal axes. The eye shape distribution and the diameters of the eyeball were compared between the two groups. Eye shape distribution, vitreous volume, and eyeball diameter were compared between MTM and non-MTM eyes.ResultsThe MTM and non-MTM groups had a total of 68 and 35 eyes, respectively. A significant difference was found in the eye shape distribution (P<0.0001) between MTM and non-MTM eyes. Most of the MTM eyes had undergone a non-uniform expansion of the eyeball, whereas the non-MTM eyes had expanded uniformly. There was no significant difference (P>0.05) in either vitreous volume or other diameters between the two groups.ConclusionsNon-uniform globe expansion and staphyloma formation might play an important role in the pathogenesis of MTM.

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“…The buckling exoplant was prepared under sterile conditions at the time of surgery using a silicone sponge, silicone band and titanium plate at the time of surgery, which was previously reported (Liu et al. ). The silicone sponge was tunnelled using a 19‐gauge needle, and the titanium plate was then inserted into the tunnel.…”

Section: Methodsmentioning

confidence: 99%

Three‐year outcomes of macular buckling for macular holes and foveoschisis in highly myopic eyes

Zhao

Lian

et al. 2019

Acta Ophthalmologica

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Background: To assess the functional and structural outcomes of macular buckling using a silicone sponge-titanium exoplant for the treatment of foveoschisis (FS) and full-thickness macular holes (FTMHs) in highly myopic eyes. Methods: Forty-nine consecutive patients with high myopia who underwent macular buckling for the treatment of FS and FTMHs were included. The outcomes measured included the anatomical success rate with FS resolution, retinal reattachment, MH closure, best corrected visual acuity (BCVA), axial length (AL) and complications of surgery. Moreover, the correlations between the BCVA at year three and series of factors, including age, duration of symptoms, baseline BCVA, AL, surgical type, preoperative macular status and severity of myopic maculopathy, were analysed. Results: This study involved 28 patients (28 eyes) with FS and 21 patients (21 eyes) with FTMHs with macular detachment. Retinal reattachment was achieved in 100% of cases, while MH closure was achieved in 76.19% of cases. The BCVA significantly improved one year after macular buckling in the FS cases and two years after macular buckling in the FTMH cases, and it remained stable throughout the rest of the follow-up period. The mean AL decreased by 2.09 mm postoperatively. No major perioperative complications were observed, although one patient needed to explant the buckling device due to intolerable diplopia. Conclusion: Macular buckling with a silicone sponge-titanium exoplant may represent a safe and effective surgical option for the treatment of FS and FTMH in highly myopic eyes. Macular buckling showed a high closure rate and virtually no tendency to recur.

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Macular Buckling Using a Three-Armed Silicone Capsule for Foveoschisis Associated With High Myopia

Abstract: Macular buckling with a three-armed adjustable silicone capsule resulted in anatomic and visual improvement in eyes with myopic foveoschisis.

Cited by 20 publications

References 32 publications

Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial

Morphological analysis and quantitative evaluation of myopic maculopathy by three-dimensional magnetic resonance imaging

Three‐year outcomes of macular buckling for macular holes and foveoschisis in highly myopic eyes

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