Macular buckle without vitrectomy for myopic macular schisis: a Canadian case series

Objective

To determine the effectiveness of a macular buckle procedure without vitrectomy for the treatment of symptomatic myopic macular schisis.

Design

Retrospective case series.

Participants and methods

All patients who underwent surgery with placement of an NPB macular buckle (AJL Ophthalmic, Miñano, Álava, Spain) without vitrectomy for symptomatic myopic macular schisis were included. Visual acuity and anatomical outcomes based on optical coherence tomography (OCT) were reviewed.

Results

Eight consecutive eyes from 7 patients were included. Six of the 7 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 preoperative axial length was 29.54 ± 1.28 mm (range, 27.88–31.96 mm). Mean preoperative best-corrected visual acuity (BCVA) was 0.71 ± 0.29 logMAR (Snellen equivalent 20/103); mean postoperative BCVA was 0.46 ± 0.44 (Snellen equivalent 20/58; p = 0.19) and 87.5% of patients maintained or improved vision. Pre- and postoperative OCT images are included and discussed within. Preoperative ellipsoid zone status and postoperative 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 postoperatively that resolved with subsequent vitrectomy. There were no other complications.

Conclusions

The macular buckle is an effective and promising therapeutic option for myopic macular schisis.