Surgical outcomes of non-fovea-sparing internal limiting membrane peeling using a double-staining technique for symptomatic myopic foveoschisis: a retrospective study

Purpose: To investigate the incidence of postoperative macular hole (MH), visual acuity, and anatomical recovery in patients who underwent a non-fovea-sparing technique using a double-staining method for symptomatic myopic foveoschisis without pre-existing macular holes. Study design: A retrospective study. Methods: We evaluated 39 eyes from 39 consecutive patients diagnosed with myopic foveoschisis from May 2017 to September 2022 at Fujita Health University Hospital. All patients underwent non-fovea-sparing internal limiting membrane peeling using a double-staining method and were monitored for 6 months postoperatively. Best-corrected visual acuity (BCVA) as measured by the logarithm of the minimum angle of resolution (logMAR), central retinal thickness (CRT), and the presence of foveoschisis were assessed using optical coherence tomography (OCT) preoperatively (pre) and at 1 month (1 M), 3 months (3 M), and 6 months (6 M) postoperatively. Results: No cases of postoperative rhegmatogenous retinal detachment were observed. A postoperative MH developed in one eye. The mean logMAR values at pre, 1 M, 3 M, and 6 M were 0.38 ± 0.37, 0.23 ± 0.33, 0.18 ± 0.25, and 0.13 ± 0.29, respectively (all P < 0.001). The mean CRTs at pre, 1 M, 3 M, and 6 M were 384.6 ± 177.2, 262.2 ± 84.4, 200.3 ± 64.9, and 185.6 ± 61.0 μm, respectively (all P < 0.001). Foveoschisis was observed in all 39 eyes (100%) preoperatively and in 17 eyes (43.6%) at 1 M, nine eyes (34.6%) at 3 M, and zero eyes (0%) at 6 M postoperatively. Conclusion: The non-fovea-sparing double-staining technique was effective in treating myopic foveoschisis without MH, leading to significant improvements in both visual function and anatomical recovery. This method may be a promising surgical option for managing myopic foveoschisis.