Article Text

Download PDFPDF

Macular buckling versus vitrectomy on macular hole associated macular detachment in eyes with high myopia: a randomised trial
  1. Xiujuan Zhao,
  2. Yonghao Li,
  3. Wei Ma,
  4. Ping Lian,
  5. Xiling Yu,
  6. Shida Chen,
  7. Xia Huang,
  8. Bingqian Liu,
  9. Lin Lu
  1. Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, Guangdong, China
  1. Correspondence to Dr Lin Lu, Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China; lulin888{at}; Dr Bingqian Liu, Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China; liubingqian{at}


Aim 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.

Methods Prospective interventional case series of eyes undergoing PPV or MB for FTMH and MD.

Main outcome measures Best-corrected visual acuity (BCVA) at postoperative month 24. Other measured outcomes include the initial surgical success rate, macular hole closure rate and the progression of myopic maculopathy.

Results A total of 53 eyes from 53 participants were included in this study (26 participants receiving MB and 27 participants receiving PPV), and finally 49 eyes from 49 participants (25 participants in the MB group and 24 participants in the PPV group) were analysed. At postoperative month 24, the BCVA had improved significantly in those that underwent either MB (p<0.001) or PPV (p=0.04). The difference between the groups was not significant (p=0.653). The surgical failure rate after the primary treatment was significantly higher in the PPV group than the MB group (25.00% vs 4.00%, respectively; p=0.04). The macular closure rate was higher in the MB 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 PPV than following MB surgery.

Conclusion Patients with high myopia obtained anatomical and functional improvements from either MB or PPV. However, MB achieved a significantly higher success rate in retinal reattachment compared with PPV.

Trial registration number NCT03433547.

  • treatment surgery
  • retina

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • XZ and YL contributed equally.

  • Contributors XH, WM and PL did colour fundal pictures and optical coherence tomography exams of the whole study. XZ and YL collected clinical data and images and edited images. SC and XYwrote the statistical analysis plan, cleaned and analysed the data, and drafted and revised the paper. LL and BL was responsible for clinical treatment of the patients, initiated this study, designed data collection tools, implemented the study and revised the draft paper.

  • Funding Supported by the Natural Science Foundation of Guangdong province of China (2018A030310232, 18zxxt72). BL and LLhave a patent for manufacturing and clinical use of the macular buckling implants.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the ethics committee of Zhongshan Ophthalmic Center and was conducted in accordance with the Principles of the Declaration of Helsinki and applicable local regulations.

  • Data availability statement Data are available on reasonable request.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.