Efficacy of Vitrectomy With Tamponade Versus No Tamponade for Myopic Traction Maculopathy: A Multicenter Study (SCHISIS Report No.1)

PURPOSE: To evaluate the influence of tamponade on the visual and anatomic outcomes of pars plana vitrec-tomy for myopic traction maculopathy (MTM). DESIGN: Multicenter, retrospective clinical cohort study. METHODS: Consecutive eyes that underwent vitrec-tomy for advanced MTM with tamponade of air, sulfur hexafluoride (SF6), or perfluoropropane (C3F8) or with-out tamponade with a minimum follow-up of 12 months were included. Main outcome measures included postop-erative visual acuity (VA) at 12 months in eyes with vs without tamponade. RESULTS: We included a total of 193 eyes (193 pa-tients) in this study; 136 eyes (70%) treated with tam-ponade were compared with 57 eyes (30%) treated with-out tamponade. Baseline characteristics did not differ significantly between the groups. Both groups showed significant visual improvement at 12 months (both P < .001). However, postoperative visual acuity and vi-sual improvement at 12 months were significantly bet-ter ( P = .003 and P = .028, respectively) in eyes with -out tamponade, although the MTM in these eyes with-out tamponade took longer to resolve ( P = .039). Retinal thickness and the ellipsoid zone were more preserved in eyes without tamponade ( P < .001 and P = .001, respec-tively). Complications such as macular holes did not dif-fer between the groups. A novel imaging finding of "schi-sis bending (accordioning)" was identified during MTM resolution.CONCLUSIONS: Vitrectomy either with or without tam-ponade for MTM was effective in improving vision in this study. However, eyes without tamponade experienced even better visual improvement and preserved retinal anatomy, despite a longer schisis resolution time. Surgery without tamponade may achieve better visual outcomes.