Review Reports - A New Model of a Macular Buckle and a Refined Surgical Technique for the Treatment of Myopic Traction Maculopathy

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Macular buckling for MTM is a promising operation. However, Three problems must be consedered: material of buckle, localization and ischemia at the top pressure site. There are some questions about this reseach: 1, This NPB was made of medical grade PMMA and covered by a thin biocompatible silicon layer, whether is there choroid or /and scleral ischemia after long-term pressure? 2. In some patients, the macula is very close to the optic nerva, how can the NPB avoid oppressing the optic nerve? What the bottom diameter of NPB is? 3, Were there postoperation axis lenth datas? at 1,3,6 month, or longer time.

Author Response

I thank the Reviewer for the comments. It is important to highlight that this manuscript describes only the new technique and the new buckle.

Following are my answers and I hope it will be accepted

I have extensive experience in buckle surgery and already reported long-term results that exclude the atrophy and ischemia on the choroid and retina and show the lack of damage to the optic nerve, even in a long term of more than 10 years. Eyes have been studied with periodical OCT, vision test, microperimetry, MRI, and angiography. The tests excluded ischemia and atrophy. A new paper has been accepted by Retina Journal and is in press. I added this citation to the text.
the MRI test after surgery excludes the touch of the optic nerve. A figure of MRI will be added to show the position of the NPB in the orbit
I have all the pre and postoperative axial lengths of more than 200 eyes operated with macular buckle. But again this manuscript is not a report of data but only the surgical techniI acknowledge the following text.

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

- How were complication rates in Section 4.3 arrived at?

- Are there different indentations heights to choose from?

- The Introduction states that indications have been previously described (ref 7). However, given that the MTM classification is described in some detail, it would be useful to the reader if indications eere briefly mention.

- Having indications in mind, what is the overall success rate of the procedure? How does it compare to other macular buckles?

Minor issues:

- Lines 78-79: “The arm is as large as the head”. Do authors mean as wide as the head?

- There is a misprint on line 84 where “has” is missing the s

- On line 221 figure reference is missing

Author Response

the data were taken by ongoing analysis which has been just recently publish after my submission (Ref 17 added) and by still unpublished data under study
the product is custom made and different height can be ordered
indications have been added
the overall rate is extremely high and data are added (Ref 17)