Posterior scleral reinforcement on progressive high myopic young patients

Abstract

Purpose: To evaluate the effect of posterior scleral reinforcement in controlling high myopic axial progression in young patients.

Methods: Only one eye of each patient had posterior scleral reinforcement surgery. Before surgery and at each postoperative follow-up, the best corrected visual acuity, intraocular pressure, refractive errors, indirect ophthalmoscopy, B-type ultrasonography, and IOLMASTER reflected light biometry were performed on both eyes. The changes of axial length and the changes of refractive errors from the baseline were compared between the surgery eyes and the contralateral eyes.

Results: Thirty patients had a mean age of 7.5 years and a mean spherical equivalent of -9.72 diopters. The mean elongation of axial length was significantly less in the surgery eye group than that in the contralateral eye group (0.75 mm vs. 0.94 mm, p < 0.0001, paired t test) after a mean follow-up of 895 days. The surgical effect was mild but maintained during the follow-up. The eyes with staphyloma gained less surgical effect when compared with the eyes without staphyloma (p = 0.0036). There was also a notable nonstatistically significant trend for younger patients to gain a larger surgical effect (p = 0.0986).

Conclusions: Posterior scleral reinforcement surgery was found effective in slowing down high myopic axial progression in young patients within the study period, but the size of the effect was small. The surgical procedure is well tolerated without vision-threatening complications.