Surgical Outcomes of Vitrectomy with Flower-Petal Fovea-Sparing Inverted Internal Limiting Membrane Flap Technique for Myopic Tractional Maculopathy with Retinal Detachment: A Retrospective Study

Background/Objectives: The optimal surgical approach for treating myopic tractional maculopathy (MTM) with retinal detachment remains unclear, particularly owing to complications associated with standard internal limiting membrane (ILM) peeling techniques and macular buckling procedures. Although the flower-petal inverted ILM flap technique is promising for large macular holes, its effectiveness in MTM without macular holes is less understood. We evaluated visual acuity and anatomical recovery in patients who underwent the flower-petal fovea-sparing inverted ILM flap technique for MTM with retinal detachment for 12 months. Methods: We retrospectively analyzed clinical data on 22 eyes of 22 consecutive patients diagnosed with MTM involving retinal detachment (Stages 3a, 3b, 4a, and 4b) between May 2019 and May 2023. All patients underwent pars plana vitrectomy using the flower-petal fovea-sparing ILM flap technique. Air, C3F8 gas, or silicone oil tamponade was used. Best-corrected visual acuity (BCVA; logMAR), intraocular pressure, axial length, central retinal thickness (CRT), and foveal contour were assessed using optical coherence tomography preoperatively and at 3, 6, and 12 months postoperatively. Results: Mean BCVA (logMAR values) significantly improved (p < 0.021). Mean CRT values significantly decreased (p < 0.001) at 3, 6, and 12 months. No significant differences in surgical outcomes were observed among tamponade materials. One patient who received air tamponade developed a postoperative macular hole. Conclusions: Our findings suggest that the flower-petal fovea-sparing ILM flap technique improves visual function and anatomical outcomes in patients with MTM and retinal detachment. This approach is a promising surgical option for managing MTM with associated retinal detachment.