Pars Plana Vitrectomy with Internal Limiting Membrane Peeling in Patients with Myopic Foveoschisis

Abstract

Objective: To report the clinical and surgical outcomes of patients with myopic foveoschisis (MF). Methods: Thirteen eyes in ten symptomatic MF patients who underwent pars plana vitrectomy (PPV) and gas tamponade with internal limiting membrane (ILM) peeling were retrospectively identified. Best corrected visual acuity (BCVA) and central foveal thickness (CFT) were assessed preoperatively and six months postoperatively. Complications during and after surgery were also recorded. Results: The median BCVA significantly improved from 20/160 to 20/100 (p = 0.03). In subgroup analysis, eight eyes (61%) demonstrated significant BCVA improvements from 20/80 to 20/50 (p < 0.001), whereas five eyes had similar BCVA with preoperative level after six months of surgery (p=0.32). The mean CFT decreased from 526 microns at baseline to 214 microns at six months of surgery (p < 0.001). Optical coherence tomography scans revealed a complete MF resolution in ten eyes (76%) and a partial MF resolution in three eyes. Peripheral retinal tear was developed in one patient during surgery and one patient had cataract after surgery, those were treated accordingly. Conclusion: PPV with ILM peeling followed by gas tamponade is a safe and effective procedure for the treatment of eyes with myopic foveoschisis. Larger studies with longer follow-ups will further establish the efficacy and safety of this procedure.

Long-term outcome of internal limiting membrane peeling with and without foveal sparing in myopic foveoschisis

“…Even with the significant difference in the follow-up period between our two groups, patients in the complete peeling group did not experience any anatomical complications during their longer follow-up duration. These results are comparable to previous published studies employing complete ILM peeling 14,20,26,27 as well as those utilizing the foveal sparing technique. 15,16,18 For median follow-up period lasted for more than 5 years, complete ILM peeling did not result in any jeopardizing effects in the study conducted by Yun and Xing.…”