Gli occhi affetti da miopia patologica possono facilmente sviluppare una sofferenza maculare caratterizzata da separazione trattiva degli strati retinici della retina centrale (foveoschisi). Tale condizione può evolvere in notevoli danni alla retina centrale con foro maculare e distacco di retina posteriore. Questo studio, effettuato da una prestigiosa scuola spagnola, ripropone la validità di strategie chirurgiche tradizionali applicate con i moderni sistemi attualmente disponibili. Il gruppo ha effettuato su 16 occhi una terapia caratterizzata dalla combinazione di chirurgia ab interno (vitrectomia) e chirurgia ab esterno (piombaggio), ottenendo buoni risultati anatomici e funzionali in tutti i pazienti.

Retina the journal of retinal and vitreous diseases
Macular Buckling for Eyes With Myopic Foveoschisis Secondary to Posterior Staphyloma

Mateo, Carlos MD; Burés-Jelstrup, Anniken MD; Navarro, Rafael MD; Corcóstegui, Borja MD.

Retina
June 2012 – Volume 32 – Issue 6 – p 1121–1128



Methods: Sixteen eyes of 16 consecutive patients with myopic foveoschisis who underwent surgery with the macular buckling procedure were studied. Pars plana vitrectomy combined with macular buckling with hard silicone implant was used in 6 eyes, whereas the other 10 eyes underwent pars plana vitrectomy and macular buckling with the Ando macular plombe.

Results: Macular buckling, with both hard silicone implant and macular plombe resulted in reduction of retinal thickness in all patients. Best-corrected visual acuity improved in 14 of 16 eyes (87.5%), whereas it remained stable or decreased in 2 eyes (12.5%). Mean preoperative best-corrected visual acuity was 20/125 (mean logarithm of the minimal angle of resolution 0.8), whereas mean postoperative best-corrected visual acuity improved to 20/50 (mean logarithm of the minimal angle of resolution 0.39). Both methods showed a similar rate of complications, the most frequent being the development of localized areas of retinal pigment epithelium atrophy.

Conclusion: Combined pars plana vitrectomy and macular buckling is an effective approach to treat myopic foveoschisis with both anatomical and visual improvement. Despite a similar complication rate with both buckling techniques, macular buckling with the Ando plombe was found to be technically easier with shorter surgical times.