SCIENTIFIC POSTER 2016_Vitrectomy and ILM Peeling With and Without Fovea-sparing IML in Bilateral Myopic Foveoschisis Natalia Ferreira

The authors describe the case of a 39-year-old female, with high myopia and bilateral myopic foveoschisis. She underwent an anterior chamber phakic IOL implantation in both eyes, 6 years before. She started to complain of decreased visual acuity and metamorphopsia since a few months ago and she was referred to vitreoretinal surgery department. On examination the best corrected visual acuity (BCVA) of right eye was 0.5 and of left eye was 0.6; Fundoscopy did not demonstrated any posterior staphiloma; OCT showed foveoschisis of entire macula with small foveal detachment in both eyes. She underwent a vitrectomy with complete and extensive ILM removal in right eye. Six months later, visual acuity of the fellow eye dropped to 0.05, foveal detachment worsened as well as macular pigmentary changes. A vitrectomy and ILM peeling with fovea sparing was performed and free ILM flap was left inverted. Ar tamponade was used. At the end of follow-up (12 and 6 months post-op for RE and LE), BCVA was 0,66 and 0,3 respectivelly. OCT of both eyes showed complete resolution of foveoschisis and fundoscopy demonstrated improvement of macular pigmentary changes. In right eye, no foveal detachment was observed but a pocket of subfoveal fluid was still present in left eye, beside progressive reduction over time. Early vitrectomy is important in foveal detachment associated to foveoschisis to obtain better functional results. Fovea-sparing IML peeling is a modified ILM peeling maneuver. This surgical technique prevents mechanical traction on the central foveal tissue and has the advantage to reduce the risc of postoperative macula hole formation. This procedure should be performed in foveoschisis with very high foveal thickness and vertical elongation of retinal layers.

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Natalia Ferreira