Long-term outcomes of early posterior scleral contraction for myopic macular retinoschisis in patients up to 30 years.

AIM: To evaluate the long-term anatomical and functional outcomes of early posterior scleral contraction (PSC) in patients up to 30 years with myopic macular retinoschisis (MRS). METHODS: This retrospective study included 21 patients (27 myopic eyes) with MRS, with or without macular detachment, who underwent PSC and had a postoperative follow-up exceeding 2 years (n = 27). Eyes with MRS underwent PSC, an extraocular procedure involving the placement of a genipin-crosslinked allogeneic strip at the posterior pole to shorten axial length and relieve vitreoretinal traction. Anatomical resolution of MRS, best-corrected visual acuity (BCVA), axial length change, were analyzed in patients with approximately 5-year follow-up records (the 13-eye main analysis cohort); while the overall safety profile was reported using the 27-eye descriptive cohort. RESULTS: At approximately postoperative year 5, complete resolution of MRS was achieved in 4 eyes (30.8%, 95% CI: 12.7%-57.6%), and partial resolution occurred in 9 eyes (69.2%, 95% CI: 42.4%-87.3%); BCVA did not improve significantly compared to the baseline level (P = 0.482, n = 13). Mean axial length shortened significantly immediately postoperatively (P < 0.001, n = 13) but gradually regressed to near baseline at approximately postoperative year 5 (P = 0.183, n = 12). In the 27-eye descriptive cohort, no eye progressed to macular hole or retinal detachment, and metamorphopsia all resolved within 8 months. No sight-threatening intra- or postoperative complications, such as cataract, iatrogenic macular hole, were observed. CONCLUSION: Early PSC may offer favorable anatomical stability and acceptable safety in young MRS patients. However, larger prospective controlled studies are needed to confirm its long-term efficacy and safety.