A Novel Episcleral Macular Buckling: Wire-Strengthened Sponge Exoplant for Recurrent Macular Hole and Retinal Detachment in High Myopic Eyes

Abstract The purpose would be to describe and evaluate a novel technique of episcleral macular buckling in postvitrectomy recurrent macular hole retinal detachment in highly myopic eyes. A ۷mm silicone sponge strengthened with a U-shaped ۰.۵mm orthodontics stainless steel wire fed along its length and hand-bent to produce L-shaped buckle of appropriate shape and length, is used. The episcleral macular buckling has performed on ۱۵ highly myopic eyes (axial length > ۳۰mm) with recurrent macular hole retinal detachment following silicone oil removal. Buckle localization has been performed by manipulating the long arm of the exoplant, under direct internal visualization, scleral marking and suturing. Successful retinal reattachment with improvement in visual acuity achieved in all ۱۵ eyes. Closure of the macular holes was confirmed by Optical Coherence Tomography. The anatomical and functional outcomes of this new technique of macular buckling appears to provide an effective and feasible means of retinal reattachment and hole closure in postvitrectomy recurrent macular hole detachment in highly myopic eyes.