ASRS 2024: Novel approach to myopic traction maculopathy

Nikoloz Labauri, MD, FVRS, founder of DAVINCI Eye Clinic in Tbilisi, Georgia, discusses his presentation, "Suspensory Macular Buckling for Myopic Traction Maculopathy" at this year's American Society of Retina Specialists (ASRS) meeting in Stockholm, Sweden

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Nikoloz Labauri, MD, FVRS:

Hi, I'm Dr Nikoloz Labauri from Tbilisi, Georgia and founder of DAVINCI Eye Clinic. Today I have spoken about the special technique for myopic traction maculopathy. So as we know, this is a disease, which comprises a large spectrum of complications, which certainly goes to the posterior pole of the eye. So this specific method is made specially to indent the posterior pole of the sclera. Today, we spoke about the six patients we have operated on plus 1 year, and the results were quite promising because, as the retinal detachments and macular holes since retinoschisis, which we had in our patients, all of them have vanished and all the holes were closed, and detached retinas were attached.

Compared to the traditional buckling devices, which we had before, this new technique actually suggests us much better results in terms of distorted vision and metamorphosia. The beauty of this buckling is that it indents a wider range, the wide surface of sclera. Instead of a dome shape indentation, it provides the flat shaped indentation. Another advantage is that it's just assembled before the implantation by the surgeon, so it doesn't need any specific custom makings and specific orders, so every surgeon has it in his or her OR. I have plenty of cases where ordering the traditional other types of [buckles] during this time period, this pathology, which is retinal detachment in high myopes, was progressing...until the devices were approaching the operating theatre.

Let's talk about the drawbacks and the dark side. The dark side of this technique is that it's a two-point fixation buckling, that it requires much much larger incisions. Instead of tugging teo muscles, we have to open the conjunctiva 360 and tuck all six muscles to slide the a buckle under the muscles, all the muscles except same medial rectus. In other words, we call it a wristwatch buckling, because indenting part is still placed exactly under the fovea, and around which covers, as I already mentioned, 7 millimeters of surface. It has a learning curve. It's the main disadvantage of this technique, and also it needs a larger incision.

Otherwise it offers a much higher satisfaction of our patients in terms of metamorphosia and distorted vision. Our results were very encouraging. However, we need larger numbers of study subjects and longer follow-up period. So I hope [to] come back with longer follow-up results by the next meeting. Thanks for having me.