Vision and Metamorphopsia Outcomes of Macular Buckling for Foveoschisis Associated Macular Detachment in Highly Myopic Eyes

Abstract

Purpose: To assess the functional outcomes in visual acuity, metamorphopsia, and vision-related quality of life (VR-QOL) and to evaluate prognostic factors after macular buckling (MB) surgery in eyes with high myopia and foveoschisis (FS) associated macular detachment (MD). Methods: Thirty-nine eyes of 39 patients with FS associated MD underwent MB surgery were enrolled. Measured outcomes comprised best-corrected visual acuity (BCVA), metamorphopsia, VR-QOL, axial length (AL), macular reattachment, and resolution of foveoschisis. Additionally, factors affecting final BCVA and metamorphopsia were analyzed. Results: At 12 months postoperatively, 36 eyes (92.31%) achieved macular reattachment, 37 eyes (94.87%) achieved complete resolution of foveoshisis, and metamorphopsia diminished in 31 eyes (79.49%). LogMAR BCVAs at baseline and months 1, 3, 6 and 12 postoperatively were 0.62±0.35 (20/83), 0.65±0.3 (20/89), 0.59±0.31 (20/77), 0.54±0.31 (20/69) and 0.46±0.27 (20/57) (P < 0.001), respectively. Metamorphopsia scores by M-CHARTS were 1.36°±0.51°, 1.04°±0.51°, 0.74°±0.47°, 0.59°±0.47° and 0.13°±0.29° (P < 0.001). All VFQ-25 subscales demonstrated significant improvement postoperatively, with the exception of “general health” (P = 0.08) and “driving” (P = 0.111). Preoperative BCVA was an independent risk factor for postoperative BCVA at month 12 (r = 0.638, P < 0.001), and the preoperative M-score was an independent risk factor for postoperative M-score at month 12 (r = 0.187, P = 0.045). Conclusions: MB surgery significantly improved BCVA, metamorphopsia, and VR-QOL in patients with FS associated MD. Preoperative BCVA and metamorphopsia score were prognostic factors for postoperative BCVA and metamorphopsia score at month 12.