Macular buckling safe and effective for foveoschisis

Macular buckling represents a safe and effective surgical option for foveoschisis (FS) and full-thickness macular holes (FTMH) in highly myopic eyes, said Lin Lu MD, China, speaking during the Sunday myopia session at the 2020 EURETINA Congress, which addressed pathogenesis, diagnosis and treatment of high myopia. Outlining three-year outcome data on this complicated surgical technique, Dr Lu said macular buckling showed a high closure rate and virtually no tendency to recur. In this approach, visual acuity can be improved and axial length can be preserved for longer. His study involved 28 patients (28 eyes) with FS and 21 patients (21 eyes) with FTMH with macular detachment. Retinal reattachment was achieved in all cases, while MH closure was achieved in 76.19%. BCVA significantly improved one year post-operatively in the FS cases and two years in the FTMH cases. The mean axial length decreased by 2.09mm post-operatively. Comparing various surgical approaches for myopic macular diseases during this session, Yasushi Ikuno MD, Japan, discussed an interesting new FS surgery technique – the foveola non-peeling technique in internal limiting membrane (ILM) – “In this technique you peel the ILM in a donut fashion and save the ILM as a central part to limit the damage of the foveola.” Also addressing this session, Kyoto Ohno-Matsui MD, Japan, said that ultra-widefield swept source OCT produces high resolution and extended size tomographic images of various tissues from the vitreous to the sclera, providing a valuable method to identify how vitreous and sclera become pathological and can “lead to vitreoretinal tractional diseases in synchronicity”.