Title : Subthreshold micropulse laser for residual subretinal fluid after vitrectomy in myopic tractional maculopathy?A randomized controlled trial
Abstract:
Myopic tractional maculopathy (MTM) represented by macular schisis is the main cause of visual impairment in high myopia patients. Therapeutically, vitrectomy can make the retina more elastic and easier to reattach by removing the vitreous cortex and/or the internal limiting membrane. However, the absorption of the subretinal fluid after vitrectomy can take a long time, and the long-term existence of subretinal fluid affects the recovery of photoreceptor cell function and ultimately affects visual prognosis.
Subthreshold micropulse laser (MPL) has the biological effect of inducing retinal pigment epithelial (RPE) cell physiological function recovery by stimulating RPE cells and ultimately producing the clinical therapeutic effect of subretinal fluid absorption. Our study intends to use MPL in the treatment of residual subretinal fluid after vitrectomy for MTM, to evaluate its effectiveness and safety. This single-surgeon study was a prospective, randomized controlled trial of eyes undergoing vitrectomy for MTM from May 2022 to August 2023 at Beijing Tongren Eye Center. The participants were randomly assigned to the subthreshold micropulse laser or control group using a random number table. The participants in the MPL group received MPL treatment by the same doctor and the procedure was repeated at 1-month intervals when necessary. The median follow-up time was 6 months. Postoperatively, BCVA was significantly improved, and macular retinal thickness was significantly reduced. The patients in the MPL group received 2.05±0.89(range 1-3) times of MPL. The Kaplan Meier curve showed no significant difference in survival curves between the two groups (P=0.33). However, the treatment group had better SRF absorption than the observation group. MPL is a safe non-invasive procedure and may help promote SRF absorption in MTM patients with residual SRF after vitrectomy surgery.
