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后巩膜加固术治疗病理性近视的疗效:一项3年随访研究

Effects of posterior scleral reinforcement in pathological myopia: a 3-year follow-up study.

作者信息

Peng Cheng, Xu Jun, Ding Xiangying, Lu Yuanyuan, Zhang Jiao, Wang Fang, Yu Jiaming, Wang Hongna, Zhang Jinsong

机构信息

Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Laboratory of Lens Research of Liaoning Province, Shenyang, China.

Laboratory of Chronic Diseases and Environmental Genomics, School of Public Health, China Medical University, Shenyang, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2019 Mar;257(3):607-617. doi: 10.1007/s00417-018-04212-y. Epub 2018 Dec 15.

Abstract

PURPOSE

To assess the effects of posterior sclera reinforcement (PSR) in refractive outcomes, choroidal thickness (CT), and retinal thickness (RT) during a 3-year follow-up in eyes with pathological myopia.

METHODS

Thirty-eight eyes of 26 adults with pathological myopia who underwent PSR (the PSR group) and 30 eyes of 18 adults with matched age and myopia who did not receive PSR treatment (the control group) were followed up with measurements of axial length (AL), spherical equivalent (SE), best corrected visual acuity (BCVA), CT, and RT at baseline, 1 and 3 months, and 1, 2, and 3 years postoperatively. Data were analyzed by repeated measures analysis of variance and independent-samples t test.

RESULTS

In the PSR group, AL, SE, BCVA, and CT were tending to be relatively stable and no statistically significant changes were found during the follow-up (all P > 0.05). In contrast, in the control group, compared with the measurements taken at baseline, AL, SE, BCVA, and CT altered gradually from 1 month onward to 3 years postoperatively. At 2-year and 3-year follow-ups, significant differences in AL, SE, BCVA, and CT were noted between the PSR group and the control group (all P < 0.05). RTs of the center subfield and the inner ring were equal to the baseline in the control group; however, RTs of the center subfield at 1 year, 2 years, and 3 years postoperatively significantly slightly reduced compared with those at the baseline in the PSR group (all P < 0.05).

CONCLUSIONS

The effects of PSR in restraining eyeball elongation, stabilizing vision, and strengthening the structure of posterior pole are more prominent 2 years or more postoperatively compared with the natural progression of pathological myopia.

摘要

目的

评估后巩膜加固术(PSR)对病理性近视患者3年随访期间屈光状态、脉络膜厚度(CT)和视网膜厚度(RT)的影响。

方法

对26例接受PSR的成人病理性近视患者的38只眼(PSR组)和18例年龄及近视程度匹配但未接受PSR治疗的成人的30只眼(对照组)进行随访,在基线、术后1个月和3个月以及术后1、2和3年测量眼轴长度(AL)、等效球镜度(SE)、最佳矫正视力(BCVA)、CT和RT。数据采用重复测量方差分析和独立样本t检验进行分析。

结果

在PSR组中,AL、SE、BCVA和CT趋于相对稳定,随访期间未发现统计学上的显著变化(所有P>0.05)。相比之下,在对照组中,与基线测量值相比,AL、SE、BCVA和CT从术后1个月到3年逐渐改变。在2年和3年随访时,PSR组和对照组在AL、SE、BCVA和CT方面存在显著差异(所有P<0.05)。对照组中心子区域和内环的RT与基线相等;然而,与基线相比,PSR组术后1年、2年和3年中心子区域的RT显著略有降低(所有P<0.05)。

结论

与病理性近视的自然进展相比,PSR在抑制眼球伸长、稳定视力和加强后极部结构方面的效果在术后2年或更长时间更为显著。

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