Long-term outcome of foveolar internal limiting membrane nonpeeling for myopic traction maculopathy.
OBJECTIVE
To investigate the long-term results of a novel technique to preserve the foveolar cone without peeling off the foveolar internal limiting membrane (ILM) during myopic traction maculopathy surgery.


METHODS
Nineteen patients (19 eyes) were retrospectively studied and divided into 2 groups by the extent of ILM peeled and followed for more than 3 years. Group 1: foveolar ILM nonpeeling group (FN) (12 eyes) and Group 2: total peeling of foveal ILM group (TP) (7 eyes). A donut-shaped ILM was peeled off, leaving a 400-μm diameter ILM over foveola with a sharp margin in FN group.


RESULTS
Macular hole was developed in 2 of the 7 eyes (28.6%) in the TP group and none in the FN group. Long-term central fovea thickness thinning and decrease of vision were found in the TP group, but not in the FN group (P < 0.05). Inner segment/outer segment line recovered in 75% of the 12 eyes in the FN group, but in only 14.3% of the 7 eyes in the TP group.


CONCLUSIONS
Preservation of the foveolar cone by foveola nonpeeling surgery correlates with better anatomical and visual results than total peel, prevents long-term foveolar retinal thinning, and successfully saves the fovea from macular hole formation.
*Department of Ophthalmology, National Taiwan University Hospital, College of medicine, National Taiwan University, Taipei, Taiwan; †Department of Medicine, School of Medicine, Chang-Gung University, Tauyuan, Taiwan; and ‡Department of Ophthalmology, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan.
Tzyy-Chang
TC
Ho
Chung-May
CM
Yang
Jen-Shang
JS
Huang
Chang-Hao
CH
Yang
Po-Ting
PT
Yeh
Ta-Ching
TC
Chen
Allen
A
Ho
Muh-Shy
MS
Chen
D000328:Adult; D001485:Basement Membrane / Q000473:pathology / Q000601:surgery*; D004396:Coloring Agents; D063928:Ependymoglial Cells / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000601:surgery*; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications* / Q000503:physiopathology; D013508:Ophthalmologic Surgical Procedures; D012167:Retinal Perforations / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D041441:Retinoschisis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green