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POSTERIOR SCLERAL CONTRACTION TO TREAT RECURRENT OR PERSISTENT MACULAR DETACHMENT AFTER PREVIOUS VITRECTOMY IN HIGHLY MYOPIC EYES

Zheng, Linyan, MD; Pan, Anpeng, MD; Zhu, Shuangqian, MD; Wu, Yue, MD; Dong, Liang, MD; Xue, Anquan, MD

doi: 10.1097/IAE.0000000000002217
Original Study: PDF Only

Purpose: To determine the efficacy of posterior scleral contraction (PSC) to treat recurrent or persistent macular detachment after previous vitrectomy in highly myopic eyes.

Methods: We reviewed the medical records of patients with high myopia and recurrent or persistent macular detachment after previous vitrectomy treated with PSC at our hospital between April 2013 and March 2017. Fourteen eyes (14 patients; mean age, 58.93 ± 11.08 years) were included. Sclera cross-linked with genipin was used for PSC. The desired axial length decrease was 0.1-fold. The reattachment rate, best-corrected visual acuity, and axial length changes were evaluated.

Results: The macular reattachment rate was 100%. In seven eyes with a silicone oil tamponade, the oil was successfully removed 2 weeks to 4 months after surgery. The best-corrected visual acuity improved significantly postoperatively (Snellen acuity improved from 20/1,000–20/400) (1.75 ± 0.90 vs. 1.34 ± 0.58 logarithm of the minimal angle of resolution; P < 0.05). Eight eyes (57.14%) improved; six eyes (43.86%) remained stable. The axial length decreased significantly postoperatively (31.32 ± 3.04 vs. 29.08 ± 3.05 mm; P < 0.05).

Conclusion: Posterior scleral contraction is safe and effective for recurrent and persistent macular detachment after previous vitrectomy in highly myopic eyes. The silicone oil is removed after PSC, and vision can be preserved in these refractory cases.

Posterior scleral contraction surgery is a safe and effective treatment for recurrent and persistent macular detachment after previous vitrectomy in highly myopic eyes.

High Myopia Department, The Eye Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.

Reprint requests: Anquan Xue, MD, The Eye Hospital of Wenzhou Medical University, Wenzhou, China, 270 Xueyuan West Road, Wenzhou 325000, Zhejiang, People's Republic of China; e-mail: xueanquandoctor@163.com

None of the authors has any financial/conflicting interests to disclose.

L. Zheng and A. Pan: literature search, figures, data analysis, data interpretation, and writing. S. Zhu: literature search and data interpretation. Y. Wu and L. Dong: data collection. A. Xue: study design and data interpretation.

© 2018 by Ophthalmic Communications Society, Inc.