Macular buckle without vitrectomy for myopic macular schisis - A Canadian case series

Abstract Body:

Purpose: To determine the effectiveness of a macular buckle procedure without vitrectomy for myopic macular schisis.

Study Design: Retrospective case series.

Methods: All patients who underwent macular buckle surgery without vitrectomy for symptomatic myopic macular schisis without macular hole were included. Visual acuity and anatomical outcomes based on optical coherence tomography (OCT) were compared pre- and post-operatively.

Results: Eight consecutive eyes from seven patients were included. Six of the seven patients were female and the mean age was 59 ± 6 years (range 49 - 66 years). The mean follow-up duration was 11 ± 7 months (range 3 - 23 months). Mean pre-operative axial length was 29.5 ± 1.3 mm (range 27.88 - 31.96 mm). Mean pre-operative best-corrected visual acuity (BCVA) was 0.71 ± 0.29 logMAR (Snellen equivalent 20/103) and mean post-operative BCVA was 0.56 ± 0.50 (Snellen equivalent 20/73; p = 0.45). Seventy-five percent of patients maintained or improved vision. Pre- and post-operative OCT images are included and discussed within. Pre-operative ellipsoid zone status and post-operative central macular buckle indentation appear to be important in visual outcomes. Two patients required a buckle repositioning for persistent schisis. One patient developed a macular hole post-operatively which resolved with subsequent vitrectomy. There were no other complications.

Conclusions: Myopic macular schisis is an uncommon and challenging complication of high myopia. The macular buckle represents a safe and promising therapeutic option for myopic macular schisis.