Xue Anquan, Bao Fangjun, Zheng Linyan, Wang Qinmei, Cheng Lingyun, Qu Jia
*MD Eye Hospital and School of Ophthalmology and Optometry (AX, FB, LZ, QW, JQ); and Institute of Ocular Pharmacology, School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou (LC), Zhejiang, China; and Jacob's Retina Center at Shiley Eye Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California (LC).
Optom Vis Sci. 2014 Apr;91(4):412-8. doi: 10.1097/OPX.0000000000000201.
To evaluate the effect of posterior scleral reinforcement in controlling high myopic axial progression in young patients.
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.
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).
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.
评估后巩膜加固术对控制年轻患者高度近视眼轴进展的效果。
每位患者仅一只眼接受后巩膜加固手术。手术前及术后每次随访时，对双眼进行最佳矫正视力、眼压、屈光不正、间接检眼镜检查、B型超声检查以及IOLMASTER反射光生物测量。比较手术眼与对侧眼眼轴长度的变化以及与基线相比屈光不正的变化。
30例患者平均年龄7.5岁，平均等效球镜度数为-9.72屈光度。平均随访895天后，手术眼组眼轴长度的平均伸长显著小于对侧眼组（0.75毫米对0.94毫米，p<0.0001，配对t检验）。手术效果轻微，但在随访期间得以维持。与无葡萄肿的眼相比，有葡萄肿的眼手术效果较差（p=0.0036）。较年轻患者获得更大手术效果的趋势也较为明显，但无统计学意义（p=0.0986）。
在研究期间发现后巩膜加固术对减缓年轻患者高度近视眼轴进展有效，但效果大小较小。该手术耐受性良好，无威胁视力的并发症。
