PURPOSE:To evaluate the outcome of vitrectomy with internal limiting membrane peeling and no gas tamponade in the treatment of eyes with myopic foveoschisis. METHODS:Medical records of 10 eyes of 9 consecutive patients with myopic foveoschisis without macular hole treated by vitrectomy were reviewed. RESULTS:The patients' refractive error was -4.00 diopters to -34.00 diopters, and axial length was 28.38 mm to 35.90 mm. Six eyes had foveal retinal detachment with retinoschisis. All cases were treated by vitrectomy with internal limiting membrane removal without gas tamponade. The mean preoperative best-corrected visual acuity was 0.61 ± 0.42 in logarithm of the minimum angle of resolution units (Snellen equivalent of 20/82). Myopic foveoschisis was reduced in 8 eyes (80%) with a single surgery. Two eyes without improvement developed a postoperative macular hole and were treated by additional vitreoretinal surgery. All 10 eyes showed anatomical repair, and 5 eyes showed improvement in best-corrected visual acuity to 0.47 ± 0.48 (Snellen equivalent of 20/60), by 17 months after the initial surgery. CONCLUSION:Vitrectomy with internal limiting membrane peeling and no gas tamponade can effectively treat some cases of myopic foveoschisis, suggesting that tractional forces at the vitreoretinal interface may contribute to the pathogenesis of myopic foveoschisis, thereby avoiding gas tamponade.

译文

目的:评价玻璃体切除术的内部限制膜剥离和无气体填塞术治疗近视眼中心凹眼的效果。
方法:回顾性分析了玻璃体切除术治疗连续9例无黄斑裂孔的近视眼中心凹患者10只眼的病历。
结果:患者的屈光不正为-4.00屈光度至-34.00屈光度,轴长为28.38 mm至35.90 mm。六只眼出现视网膜中央凹并发视网膜中央凹。所有病例均通过玻璃体切除术切除了内部限制膜而未发生气塞。术前最佳矫正视力的平均值为分辨率单位最小角度的对数(Snellen等效为20/82)为0.61±0.42。一次手术可减少8眼(80%)的近视眼中心凹病。两只没有改善的眼睛在术后出现了黄斑裂孔,并接受了额外的玻璃体视网膜手术治疗。在初次手术后的17个月内,所有10眼均显示出解剖修复,并且5眼表现出最佳矫正视力改善至0.47±0.48(Snellen等效为20/60)。
结论:玻璃体切除术具有内部限制膜剥离,无气体压塞可有效治疗某些近视眼中心凹的病例,提示玻璃体视网膜界面的牵引力可能是导致近视眼中心凹的原因,从而避免了气体填塞。

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