ABSTRACT
A 16-year-old boy with elevated hyperopia presented to the office with a 24-h history of bilateral blurred vision, mainly of the left eye, and bilateral central serous chorioretinopathy. He showed a clinically recognizable bacillary layer detachment in one eye and excellent multimodal diagnostic image correlation, with the best-corrected visual acuity as 20/400. He had bilateral serous retinal detachment, as confirmed by optical coherence tomography. Laser photocoagulation was performed with good results, and reestablishment of the foveal anatomical structure was documented 16 days after treatment.
ABSTRACT
This case report describes a novel surgical technique for the treatment of macular hole and focal macular detachment associated with high myopia and posterior staphyloma. A 65-year-old female presented with a stage 3C myopic traction maculopathy and VA of 20/600. OCT examination confirmed a macular hole of 958 µm diameter, posterior staphyloma, and macular detachment. We performed combined phacoemulsification surgery with 23G pars plana vitrectomy; the anterior capsule was preserved and divided into two equal circular laminar flaps. We proceeded with central and peripheral vitrectomy, brilliant blue staining, and partial ILM peeling; capsular sheets were introduced sequentially in the vitreous chamber, the first one was implanted below the hole and attached to pigment epithelium, the second lamina was inserted into the hole, and the remaining portion of ILM was implanted crosswise below the edges of the hole. Macular-hole closure and progressive reapplication of the macular detachment were obtained, with a final VA of 20/80. Treatment of macular holes and focal macular detachment in high myopic eyes is complex, even for experienced surgeons. We propose a new technique with additional mechanisms based on anterior lens capsule and internal limiting membrane tissue properties that showed functional and anatomical improvement and could be considered an alternative treatment.