Efficacy Of Posterior Scleral Reinforcement Research Articles

Effect and safety posterior scleral reinforcement on controlling myopia in children: a meta-analysis

PurposeThe aim of this meta-analysis was to assess the efficacy of posterior scleral reinforcement (PSR) on the control of pediatric myopia. Electronic databases were systematically searched.MethodsStandardized mean differences (SMDs) of outcomes were calculated. Eight studies with 357 patients with pediatric myopia were included. The SMD for the increase in mean axial length (AL) in the PSR and control group was − 1.19 (95% CI − 1.71, − 0.68). ResultsThe SMD for decrease of best-corrected visual acuity (BCVA) LogMAR in the PSR and control group was 0.85 (95% CI 0.28, 1.43). The SMD for change in intraocular pressure (IOP) at the time of surgery and at the end of the follow-up period in the PSR group was − 0.01 (95% CI − 0.48, 0.47).ConclusionThis meta-analysis indicates that PSR surgery may be an effective therapeutic strategy to control the progression of myopia in childhood with acceptable adverse effects.

Efficacy of Posterior Scleral Reinforcement in Children with High Myopia: A Systematic Review and Meta-Analysis

Purpose: The purpose of this meta-analysis is to evaluate the effect of posterior scleral reinforcement (PSR) on axial length (AL), spherical equivalents (SE) and best corrected visual acuity (BCVA) in children with high myopia. Methods: The databases PubMed, EMBASE, Wanfang Database, CNKI, CSTJ and Cochrane Library from inception to March 2021 were searched to identify the relevant studies which evaluated the efficacy of PSR for patients under 18 years old with high myopia. The main parameters include AL, SE and BCVA. Revman software version 5.3 was used to perform the statistical analyses. Results in proportion with 95% confidence interval were calculated using dersimonian-laird model. Results: 8 studies including 383 PSR treated and 281 control eyes were finally included. Our analysis indicated that PSR could slow down the increase of AL and the loss of vision loss (P<.01). However, in the subgroup with a follow-up period shorter than three years, there was no statistical difference in BCVA changes between the PSR and control groups (WMD=-0.02, 95%CI -0.07 to 0.04, P=.58, I2=0%). The BCVA changes is significant after 3 years follow up (WMD=-0.13, 95%Cl -0.21 to -0.05, P=0.007). Conclusion: PSR can benefit children in controlling the growth of AL, SE and decrease of visual acuity. 3 years after PSR may be a critical time point. Given the limitations in our study, more research with larger sample sizes and more accurate data are required to reach a firmer conclusion.

Evaluation on the efficacy of posterior scleral reinforcement for the treatment of high myopia with post-scleral staphyloma

Objective To evaluate the efficacy of posterior scleral reinforcement in patients with high myopia with post-scleral staphyloma. Methods The data of 102 eyes of 62 cases of high myopia with post-scleral staphyloma in this hospital from Jun.2016 to Apr.2018 were collected. All cases received posterior scleral reinforcement.The followed-up time was 6-10 months. Results The differences of postoperative diopter, axial length and the best corrected visual acuity were statistically significant between before and after surgery (P 0.05). No serious complication such as ischemic optic neuropathy, retinal detachment or infection occurred. Conclusion Posterior scleral reinforcement in the treatment of high myopia with post-scleral staphyloma can effectively control the diopter and axial growth, as well as improve the visual acuity. Key words: Myopia, high; Staphyloma, posterior sclera; Reinforcement, posterior scleral; Parameters, hemodynamic

Vitrectomy combined with posterior scleral reinforcement for high myopic macular retinoschisis

Objective To investigate the clinical efficacy of vitrectomy combined with internal limiting membrane peeling and posterior scleral reinforcement for the treatment of high myopic macular retionschisis. Methods The data of 37 eyes of 37 patients with high myopia and macular splitting who were treated in our hospital from Mar. 2014 to Feb. 2017 were analyzed retrospectively. All patients were treated with posterior scleral reinforcement combined with vitrectomy, internal limiting membrane peeling and intravitreal injection of air. Among them partial cataract patients were treated with phacoemulsification and intraocular lens implantation. The follow-up time was 12 months. Results After operation, the retinoschisis was completely closed in 37 eyes. The thickness of central macular retina at 3 months after operation was significantly lower than that before operation (P<0.05). The best corrected visual acuity at 6 months postoperatively was significantly higher than preoperatively(P<0.05), and the visual acuity at 12 months after operation was higher than that at 6 months after operation (P<0.05). The axial length at 6 months after operation was significantly shorter than that preoperatively(P<0.05), and the axial length at 12 months after operation was shorter than that at 6 months after operation (P<0.01). Transient high intraocular pressure occurred in 2 eyes. No secondary surgery treated or other complication occurred. Conclusion The clinical efficacy of posterior scleral reinforcement combined with vitrectomy and internal limiting membrane peeling for the treatment of high myopic macular retionschisis is good. Key words: Reinforcement, posterior sclera; Retinopathy; Myopia, high; Splitting, macula

Long-term efficacy of posterior scleral reinforcement for maculoschisis in high myopia

Objective To evaluate long-term efficacy of posterior scleral reinforcement for the treatment of maculoschisis in high myopic eyes. Methods The data of 37 eyes of 30 cases with maculoschisis in high myopia eyes were collected and analyzed retrospectively, they underwent scleral reinforcement with allodural or allogeneic sclera, and the followed-up time was 5 years. Results After surgery, all cases were examined with optical coherence tomography(OCT). The splitting cavity of retina disappeared in 33 eyes(89.2%). The splitting wasn’t improved in 2 eyes. The macular hole occurred in 2 eyes. After surgery, the refractive degree was lower, and the difference was statistically significant(χ2=47.910, P=0.000). The best corrected visual acuity (BCVA) were improved after surgery, and the difference was statistically significant(t=5.034, P=0.011). The mean length of the ocular axis in patients before surgery was (29.42±2.67) mm. After 6 months, 1, 3 and 5 years, the length of axis were respectively: (28.21±1.87)mm, (28.63±1.62)mm, (29.16±2.15)mm and (29.31±2.42)mm. Conclusion Posterior scleral reinforcement surgery in the treatment of high myopia and maculoschisis is effective , it can stable eye axis and improve visual acuity. Key words: Maculoschisis, high myopia; Posterior scleral reinforcement; Efficacy, long-term

The efficacy of posterior scleral reinforcement for macular retinoschisis in pathological myopia

Objective To evaluate the clinical curative effect of posterior scleral reinforcement for macular retinoschisis in pathological myopic patients. Methods A prospective study was conducted, in which 36 pathological myopia patients(36 eyes)with myopic foveoschisis were enrolled and divided into two groups according to the treatments: 24 patients (24 eyes) voluntarily underwent posterior scleral reinforcement (PSR, operation group) and 12 patients (12 eyes) didn't receive operation (control group) .There are no statistical differences (P>0.05) in age, gender, length of axis oculi, spherical equivalent between the 2 groups. All patients were examined by best corrected visual acuity (BCVA), macular retinoschisis types, central foveal thickness (CFT), maximum foveal thickness (MxFT) . Patients in operation group were scheduled to a follow-up 3rd, 6th, and 9th month after surgery respectively. Patients in control group all were followed up once every three months. A contrast observation was made on the changes of BCVA, CFT, MxFT, findings of the foveoschisis and the complications of the surgery between groups. Results Compared with the preoperation after 9 month follow-up: in the operation group, the BCVA was significantly increased postoperatively (Z=-3.43, P=0.01), the mean CFT was significantly decreased postoperatively (Z=-2.71, P=0.007), while the MxFT which was not significantly decreased postoperatively (Z=-0.67, P=0.503). In the control group, there was no significant change in BCVA (Z=-1.840, P>0.05), the CFT and the MxFT were signi? cant increased respectively (Z=-2.803, -2.04; P<0.05). In the operation group, there were 6 (25.0%) of the 24 eyes get complete resolution of the foveoschisis; 16 (66.7%) of them is not completely attached however the retinoschisis was significantly decreased; only 2 eyes developed to macular hole the other getting worse and the foveal thickness was increased. In the control group no one get complete resolution of the myopic foveoschisis, and 2 eyes developed to retinal detachment in 6 and 8 month respectively. There was no complications such as post-operative intra-ocular pressure increased, subretinal hemorrhage, macular epiretinal membrane, endophthalmitis, vortex vein circumfluence obstacle and anterior ocular ischemia syndrome occurred after surgery. Conclusions Posterior scleral reinforcement surgery was found effective in improving the visual acuity, reducing the CFT. No obvious complications were found during and after the surgery. Key words: Myopia, degenerative/complications; Retinal perforations/surgery; Scleroplasty

Posterior sclera reinforcement and phakic intraocular lens implantation for highly myopic amblyopia in children: a 3-year follow-up.

To study the safety and efficacy of posterior scleral reinforcement (PSR) combined with phakic intraocular lens (PIOLs) implantation for highly myopic amblyopia in children. This study included eight highly myopic children (11 eyes) who failed in conventional therapy for amblyopia using various combination of spectacles, contact lenses, and intensive patching before enrollment into this study. They were treated sequentially with PSR and PIOL implantation, and were followed up for 3 years after surgery. Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) in LogMAR, spherical equivalent power (SE), and complications were evaluated. Before surgery, the mean UCVA was 1.59±0.33, BCVA, 0.74±0.37, SE, -17.57±5.56D, the axial length (AL), 30.09±2.18 mm. After PSR, BCVA improved one line in three patients, the rest were unchanged, and AL was unchanged among all cases. Six eyes of three patients were implanted with an iris-claw PIOL and five eyes of five patients were implanted with a posterior PIOL. After completion of treatment, the mean UCVA was 0.44±0.21, BCVA 0.38±0.24, SE -0.54±0.74 D, and AL 30.35±2.29 mm. No patient experienced complications. Combined PSR and PIOL implantation treatment for highly myopic amblyopia in children is safe and effective.