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Combined Vitrectomy With Macular Buckling In High Myopic Eyes With Macular Hole Retinal Detachment: A Pilot Study Of A Novel Snail-Tipped Exoplant

Authors Sun HJ, Kim C, Park K, Lee SJ

Received 21 August 2019

Accepted for publication 23 October 2019

Published 18 November 2019 Volume 2019:13 Pages 2233—2242


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Supplementary video of ID 227954

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Hae Jung Sun, Charm Kim, Kibum Park, Sung Jin Lee

Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul, South Korea

Correspondence: Sung Jin Lee
Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, #59 Daesagwan-ro, Yongsan-gu, Seoul 140-743, South Korea
Tel +82-2-709-9355
Fax +82-2-710-3196

Purpose: To evaluate the efficacy of a novel snail-tipped exoplant for macular buckling combined with vitrectomy in high myopic eyes with macular hole retinal detachment.
Patient and methods: A novel exoplant was simply prepared with a 5 × 3 mm silicone sponge strengthened in the center with a malleable titanium plate. One end was bent to make a rolled tip like a snail shell to be placed under the macula. Combined vitrectomy with macular buckling using this exoplant was performed in eight consecutive cases. The long arm of the exoplant was manipulated manually to fit the curvature of the eyeball and the length was trimmed appropriately after scleral suturing of the exoplant.
Results: Retinal reattachment was achieved in all cases (100%) and macular hole closure was confirmed in 6 eyes (75%). The mean best-corrected visual acuity improved from 1.53 ± 0.73 LogMAR preoperatively to 1.14 ± 0.59 LogMAR to postoperatively (p = 0.063). The mean pre- and postoperative AL was 28.44 ± 1.86 mm and 27.60 ± 1.83 mm, respectively (p = 0.016). The mean follow-up period was 15.4 months and no buckle-related complications such as diplopia, infection or exposure of the exoplant were noticed during the period.
Conclusion: This exoplant could easily be prepared with readily available materials in the operating room and it was well tolerated with favorable anatomic results in high myopic eyes. Further studies of increased number of patients with long-term follow-up will be necessary.

Keywords: exoplant, high myopia, macular buckling, macular hole retinal detachment, posterior staphyloma

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