Study on Macular Buckling vs. Pars Plana Vitrectomy

According to a recent study published in the British Journal of Ophthalmology, patients with high myopia obtained anatomical and functional improvements from either macular buckling or pars plana vitrectomy.

Study Overview

A study was conducted to compare the efficacy of macular buckling (MB) and pars plana vitrectomy (PPV) for full-thickness macular holes (FTMH) and associated macular detachment (MD) in highly myopic eyes. This was a prospective interventional case series of eyes undergoing PPV or macular buckling for FTMH and MD. Best-corrected visual acuity (BCVA) was measured at postoperative month 24. Other measured outcomes included the initial surgical success rate, macular hole closure rate, and myopic maculopathy progression.

Results

• A total of 53 eyes from 53 participants were included in this study (26 participants receiving macular buckling and 27 participants receiving pars plana vitrectomy), and finally 49 eyes from 49 participants (25 participants in the macular buckling group and 24 participants in the PPV group) were analysed.
• At postoperative month 24, the BCVA had improved significantly in those that underwent either macular buckling (p<0.001) or pars plana vitrectomy (p=0.04). The difference between the groups was not significant (p=0.653).
• After the primary treatment, the surgical failure rate was significantly higher in the pars plana vitrectomy group than the macular buckling group (25.00% vs 4.00%, respectively; p=0.04).
• The macular closure rate was higher in the macular buckling group compared with the PPV group, but the difference was not statistically significant (64.00% vs 58.33%, respectively; p=0.45).
• Myopic maculopathy development may be more severe following pars plana vitrectomy than following macular buckling surgery.

Thus, patients with high myopia obtained anatomical and functional improvements from either macular buckling or pars plana vitrectomy. However, macular buckling achieved a significantly higher retinal reattachment success rate than pars plana vitrectomy.

Reference

Macular buckling versus vitrectomy on macular hole associated macular detachment in eyes with high myopia: a randomised trial by Xiujuan Zhao et al. published in the British Journal of Ophthalmology.

https://bjo.bmj.com/content/106/4/582