Choi M Y, Yu Y S
Department of Ophthalmology, College of Medicine, Chungbuk National University Hospital, Heungduk-Gu, Cheongju, Korea.
Graefes Arch Clin Exp Ophthalmol. 2000 Sep;238(9):774-8. doi: 10.1007/s004170000162.
There have been a series of reports indicating that scleral buckling (SB) surgery may induce high myopia in advanced retinopathy of prematurity. The mechanism of SB on refractive change in children, however, is not clearly known. We designed this study to investigate the effects of SB on refractive error and ocular growth in young rabbits and demonstrate their mechanisms.
For the study, SB surgery was performed on the right eyes of nine 5-week-old rabbits and 11 8-week old rabbits, with encircling buckle. The left eyes were monitored for control. Spherical equivalent, corneal power, and axial length were measured before SB and postoperatively at 2, 4, and 8 weeks. We compared the experimental group with the control group and analyzed the influence of age at the time of operation.
In the control group of eyes, corneal power decreased, axial length increased, and spherical equivalent developed emmetropization with aging. In all eyes that underwent SB surgery, high myopia developed, with the increase in axial length as a major factor in inducing myopia. These changes were greater in the 5-week-old group than in the 8-week-old group. In the eyes that underwent SB surgery, axial length increased more than the eyes in the control group up to 2 weeks after surgery, but ocular growth was arrested after that time.
SB in young rabbits effects ocular growth and results in high myopia, and an increase of axial length plays a major role in this mechanism. Also, the difference in the effects of SB according to age at the time of surgery may suggest that SB in premature infants could induce a significant axial myopia and secondary amblyopia.
已有一系列报告表明，巩膜扣带术（SB）可能会在早产儿晚期视网膜病变中诱发高度近视。然而，SB对儿童屈光变化的机制尚不清楚。我们设计了本研究，以探讨SB对幼兔屈光不正和眼球生长的影响，并阐明其机制。
在本研究中，对9只5周龄和11只8周龄的幼兔右眼进行SB手术，并使用环扎带。左眼作为对照进行监测。在SB手术前以及术后2周、4周和8周测量等效球镜度、角膜屈光力和眼轴长度。我们将实验组与对照组进行比较，并分析手术时年龄的影响。
在对照组眼中，角膜屈光力下降，眼轴长度增加，等效球镜度随着年龄增长而发展为正视化。在所有接受SB手术的眼中，均出现了高度近视，眼轴长度增加是诱发近视的主要因素。这些变化在5周龄组比8周龄组更为明显。在接受SB手术的眼中，术后2周内眼轴长度的增加超过了对照组，但此后眼球生长停止。
幼兔的SB会影响眼球生长并导致高度近视，眼轴长度增加在这一机制中起主要作用。此外，根据手术时年龄不同，SB效果存在差异，这可能表明早产儿的SB可能会诱发显著的轴性近视和继发性弱视。
