Myopic traction maculopathy is a general term for a class of diseases including vitreomacular traction, foveoschisis, and macular hole. Posterior staphyloma plays a vital role in the occurrence and development of myopic traction maculopathy. At present, there is no uniform standard for the timing and method of surgery for myopic traction maculopathy. Based on OCT examination, the classification of traction maculopathy and the degree of visual function damage are important basis for judging the timing of surgery at this stage. Pars plana vitrectomy has been widely used in the treatment of myopic traction maculopathy, but for those with a long axis, the operation is complicated and the effect is not ideal. Macular buckling can effectively alleviate the traction caused by posterior staphyloma, but this surgery has a certain learning curve for clinicians, surgical materials need to be improved and perfected, and more evidence-based medical evidence is needed. We believe that with the continuous clinical understanding of myopic traction maculopathy, surgical treatment will be more rationalized and better treatment results will be achieved.
Pathological myopia, characterized by progressive elongation of the axial length and formation of posterior staphyloma, is accompanied by chorioretinal irreversible degeneration. It is also the focus and biggest challenge of myopia control and blindness prevention. For managing progressive early-onset pathologic myopia and myopic traction maculopathy, episcleral pressurization of macula is a practical option. It can be divided into posterior scleral reinforcement surgery and macular buckling surgery according to the presence or absence of operative top pressure ridge after surgery, both of which are different in terms of implanted materials, procedures and indications. The implanted materials, procedures and indications are different between the two. Under the background of soaring prevalence of myopia, it is necessary to modify and cautiously popularize the techniques of episcleral pressurization of macula to provide high level clinical evidence for management of pathological myopia.
High myopia is a disease with a high incidence rate and an increasing trend, which could lead to irreversible visual impairment worldwide. Myopia traction maculopathy (MTM), belonging to one of the pathological changes of high myopia, could cause vision damage and even blindness in patients. Recently, a new classification of MTM based on optical coherence tomography can effectively evaluate the condition of patients and is helpful for the diagnosis and treatment of MTM. Moreover, the improvement of internal limiting membrane peeling method and the innovation of macular buckle material provide new ideas for the treatment of MTM based on traditional surgery. New treatment such as vitreal traction release laser surgery, enzymatic vitreolysis and posterior scleral crosslinking have gained increasing attention. By combining these new treatments with artificial intelligence, 3D printing technology and advanced vitrectomy equipment, it is hoped that a safer and more effective treatment for MTM will be found in the future.