Surgical outcome and late-onset complications 5 years after pars plana vitrectomy for myopic traction maculopathy

To determine the long-term effects of vitreoretinal surgery to treat myopic traction maculopathy (MTM) and to determine the differences in the postoperative results between fovea-sparing internal limiting membrane (ILM) peeling (FSIP) and total ILM peeling (TP).

We studied 209 eyes of 189 patients with high myopia (refractive error >6.0 dioptres (D) or an axial length ≥26.5 mm) that had undergone pars plana vitrectomy (PPV) for MTM. The inclusion criteria were high myopia and a postoperative follow-up period of >5 years. Surgical outcomes were compared between eyes treated with FSIP and those with TP.

There were 28 eyes in the FSIP group and 38 eyes in the TP group. The preoperative and 1, 3 and 5 years postoperative best-corrected visual acuity was not significantly different between the FSIP group and the TP group. For eyes with a postoperative full-thickness macular hole (MH), there were 4 (14.3%) eyes in the FSIP group and 3 (7.9%) eyes in the TP group. The rate of the development of a postoperative MH was not significantly different between the two groups (p=0.668). There were 0 eyes in the FSIP group and 4 (10.5%) eyes in the TP group that developed postoperative macular atrophy (MA). This difference was not significant (p=0.212).

Fovea sparing is useful both for improving vision and preventing complications. We suggest that FSIP has the possible benefit of avoiding postoperative MA.