Vitrectomy and scleral imbrication in patients with myopic traction maculopathy and macular hole retinal detachment.
OBJECTIVE
To determine the outcomes of vitrectomy with scleral imbrication in highly myopic eyes with either myopic traction maculopathy (MTM) or macular hole retinal detachment (MHRD).


METHODS
The medical records of 17 patients who had undergone vitrectomy with internal limiting membrane (ILM) peeling and scleral imbrication for MTM or MHRD were reviewed. The best-corrected visual acuities (BCVAs), the axial length, the macular hole (MH) closure rate, and the shape of the posterior segment determined by optical coherence tomography were evaluated. Three-dimensional magnetic resonance imaging (3D-MRI) was also performed on five eyes.


RESULTS
The postoperative BCVA improved significantly from 0.76 ± 0.39 logarithm of the minimum angle of resolution (logMAR) units to 0.53 ± 0.35 logMAR units (P = 0.0004). The axial length decreased from 29.42 ± 1.81 mm to 27.97 ± 1.71 mm at 1 month. The MTM was resolved or decreased in all eyes. The MH was closed in 44 % of the MHRD eyes, and the retina was reattached in all of the MHRD eyes. The horizontal distance between the optic disc and the bottom of the posterior staphyloma was significantly decreased at 1 month (P = 0.012) but not at later times. The 3D-MRI images showed a reduction in the distance between the bottom of the posterior staphyloma and the center of the eye (P = 0.029) and a flattening of the posterior staphyloma (P = 0.010).


CONCLUSIONS
Vitrectomy with ILM peeling and scleral imbrication may be helpful in treating MTM and MHRD by reducing the degree of curvature of the posterior staphyloma.
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Yoshimasa
Y
Ando
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan. hirakata@eye-center.org.
Akito
A
Hirakata
Department of Radiology, Kyorin University School of Medicine, Tokyo, Japan.
Arisa
A
Ohara
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Reiji
R
Yokota
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Tadashi
T
Orihara
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Kazunari
K
Hirota
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Takashi
T
Koto
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Makoto
M
Inoue
D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications* / Q000175:diagnosis; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012590:Sclera / Q000601:surgery*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
Macular hole retinal detachment; Myopic traction maculopathy; Optical coherence tomography; Scleral imbrication; three-dimensional magnetic resonance imaging