Posterior pole remodeling in myopic traction maculopathy: A combined approach using scleral imbrication and pars plana vitrectomy
M. Prabhu Shanker, Priyanka PatelPurpose:
To evaluate the anatomical and functional outcomes of combining scleral imbrication with pars plana vitrectomy (PPV) and gas tamponade as a primary surgical approach for myopic traction maculopathy (MTM).
Methods:
Video 1 presents a patient with MTM associated with high myopia who underwent primary surgery combining scleral imbrication, PPV, and intraocular gas tamponade. The surgical technique involves removal of the vitreous with posterior hyaloid detachment, followed by placement of posteriorly located scleral imbrication sutures to reduce axial length and modify the posterior curvature. SF6 gas was used as tamponade. Pre- and postoperative outcomes, including best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (OCT) imaging, were analyzed over a 6-month follow-up period.
Results:
The operated eye demonstrated resolution of macular detachment on OCT. The mean axial length was reduced postoperatively. BCVA improved, with no major intraoperative or postoperative complications. The posterior pole showed reconfiguration with improved foveal contour.
Conclusion:
Scleral imbrication combined with PPV and gas tamponade appears to be a safe and effective primary surgical strategy for MTM in highly myopic eyes. This approach addresses both vitreoretinal traction and posterior staphyloma, facilitating anatomical restoration and functional recovery.