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Combined fovea-sparing internal limiting membrane peeling with internal limiting membrane flap technique for progressive myopic traction maculopathy

  • Retinal Disorders
  • Published:
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Abstract

Background

To present the anatomical and functional outcomes of combined fovea-sparing internal limiting membrane peeling (FSIP) with internal limiting membrane flap (ILMF) for myopic traction maculopathy (MTM).

Methods

This is a retrospective, observational study. Included were 66 eyes of 62 patients who underwent vitrectomy with combined FSIP and ILMF (or modified ILMF) for MTM with a minimal follow-up of 6 months. Thirty-one eyes were treated with FSIP, and 35 with modified ILMF.

Results

The post-operative best-corrected visual acuity (BCVA) improved from 20/148 to 20/87 in the FSIP group (p < 0.001), and from 20/121 to 20/66 in the modified ILMF group (p < 0.001). The post-operative macular thickness (MT) reduced after FSIP (from 739.58 to 223.81 μm, p < 0.001) and modified ILMF (from 706.43 to 236.59 μm, p < .001). The degree of the improvement of BCVA and MT in both groups was insignificant. The incidence of a post-operative macular hole (MH) was 9.7% (3/31 eyes) with FSIP and 0% (0/35 eyes) with modified ILMF. All patients with a MH had foveoschisis in association with a lamellar hole (LMH) pre-operatively. After controlling the surgical technique, pre- and post-operative MT, follow-up duration, myopic atrophy maculopathy, and FD, the surgical technique showed significant effects on post-operative MH in all cases (p = 0.022) and in those with pre-operative LMH (p = 0.029).

Conclusion

Our pilot study showed both methods result in significant anatomical and functional improvement. The combined FSIP with ILMF method may prevent post-operative macular hole development in cases with MTM and LMH.

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Authors and Affiliations

  1. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan

    Jih-Pin Lin & Chung-May Yang

  2. Department of Ophthalmology, National Taiwan University Hospital, Yunlin, Taiwan

    Jih-Pin Lin

  3. Department of Ophthalmology, College of Medicine, National Taiwan University, No. 7, Chun-Shan S. Rd., Taipei City, 100, Taiwan

    Chung-May Yang

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  1. Jih-Pin Lin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jih-Pin Lin and Chung-May Yang. The first draft of the manuscript was written by Jih-Pin Lin and Chung-May Yang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chung-May Yang.

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This study was reviewed and approved by the institutional review board and ethics committee of National Taiwan University Hospital. (IRB: 201910085RINB).

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The authors declare no competing interests.

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Lin, JP., Yang, CM. Combined fovea-sparing internal limiting membrane peeling with internal limiting membrane flap technique for progressive myopic traction maculopathy. Graefes Arch Clin Exp Ophthalmol 260, 489–496 (2022). https://doi.org/10.1007/s00417-021-05397-5

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  • DOI: https://doi.org/10.1007/s00417-021-05397-5

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