Vitrectomy with internal limiting membrane peeling for myopic foveoschisis

Abstract

Objective To evaluate the efficacy of 23G vitrectomy with internal limiting membrane (ILM) peeling and perfluoropropane (C3F8) tamponade to treat myopic foveoschisis.Methods Twentyeight eyes of 25 patients with myopic foveoschisis were analyzed retrospectively.23G vitrectomy was performed with 15％C3F8 tamponade.The patients were divided into two groups according to the treatment:15 eyes of 13 patients were in group A with a combination of ILM peeling; 13 eyes of 12 patients were in group B without ILM peeling.The follow up period was 6-11 months.The best corrected visual acuity(BCVA) and optical coherence tomogrphic(OCT) finding of the foveal thickness before and 1 m,3 m,6 m after operation were obtained and compared.Results The postoperative BCVA increased significantly in both groups (Group A t=-6.167,-10.724,-9.510,Group B t=-7.426,-7.754,-9.381,P ＜0.05).And the difference of vision improvement between the two groups was no significant at each time point after operation (t =0.239,P =0.813 ;t =-0.408,P =0.686 ; t =-759,P =0.455).The OCT image showed the mean foveal thickness was decreased postoperatively (P ＜ 0.05).And the difference of thickness decrease was significant between the two groups,at the 3rd (t =-2.998,P =0.006) and 6th (t =-3.800,P =0.001) month postoperatively.The foveal thickness of Group A was thinner than that of Group B.During the followup,one eye in the group A developed macular hole and retinal detachment 1 month after surgery.Conclusion 23G vitrectomy with or without ILM peeling and C3F8 tamponade is safe and effective for myopic foveoschisis,and ILM peeling can improve the reattachment of the myopic foveosehisis,but increase the risk of the macular hole. Key words: Myopia, high; Retinoschisis; Vitrectomy, 23G; Peeling, internal limiting membrane ; Gas tamponade, perfluoropropane