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Klin Monbl Augenheilkd 2022; 239(09): 1125-1131
DOI: 10.1055/a-1328-2586
Klinische Studie

Results with Posterior Scleral Reinforcement for Progressive Highly Myopic Children in Hungary

Erfahrungen mit der Skleroplastik in Ungarn bei Kindern mit progessiver, hochgradiger Myopie
Noémi Széll
1   Ophthalmologie, Kenézy Gyula University Hospital of Debrecen Medical University, Debrecen, Hungary
,
Adrienn Boross
1   Ophthalmologie, Kenézy Gyula University Hospital of Debrecen Medical University, Debrecen, Hungary
,
Andrea Facskó
2   Ophthalmologie, University of Szeged Faculty of Medicine, Szeged, Hungary
,
Zoltán Sohajda
1   Ophthalmologie, Kenézy Gyula University Hospital of Debrecen Medical University, Debrecen, Hungary
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Abstract

Purpose We have been performing posterior scleral reinforcement in our ophthalmological department since 1992 on progressive highly myopic eyes. Here, we report on our results with this technique in the foregoing 7 years in a retrospective comparative design.

Methods Thirty-eight eyes of 32 patients, operated according to Snyder-Thompsonʼs method, were enrolled in this study, and a control group of 9 age- and myopia-matched childrenʼs 14 eyes was built for comparison. Pre- and postoperative best-corrected visual acuity, subjective refractive error (spherical equivalent of spectacle dioptres), and axial length were recorded. Changes within groups were calculated, as well as baseline parameters and their changes during follow-up, and compared between the groups. Correlation analysis was performed to identify factors that could influence myopia progression.

Results Myopic progression was significantly lower in the operated than in the nonoperated group, both in terms of mean annual axial length as well as refractive error changes (0.21 ± 0.08 mm versus 0.49 ± 0.19 mm and 0.18 ± 0.29 D versus 0.6 ± 0.33 D, respectively). Mean overall visual improvement was more explicit in operated eyes as compared to those left untreated (0.15 ± 0.09 versus 0.01 ± 0.1). No association of any factor with myopia progression could be identified. We encountered no serious or lasting complications.

Conclusion In our clinical practice, posterior scleral reinforcement according to Snyder-Thompson proved to be a safely applicable and effective surgical method to stop or significantly retard pathological increases in axial length and dioptres, and thus can help prevent the onset of myopic degenerative lesions, and irreversible visual impairment in the long run.

Zusammenfassung

Ziel Auf unserer ophthalmologischen Station führen wir seit 1992 Skleroplastik in Augen mit hochgradiger, progressiver Myopie durch. In unserer Publikation stellen wir retrospektive, die mit dieser Operation gesammelten vergleichenden Erfahrungen der letzten 7 Jahre vor.

Patienten und Methoden Wir haben 38 Augen von 32 Patienten mit der Skleroplastik nach Snyder-Thompson operiert und bildeten eine Kontrollgruppe aus 14 Augen von 9 Kindern, die im Alter und in dem Grad der Myopie korrelierten. Der bestkorrigierte prä- und postoperative Visus (dezimal), die subjektive Refraktion (sphärisches Äquivalent der Brillendioptrie) bzw. die Bulbuslänge wurden ausgewertet. Die Veränderungen innerhalb von Gruppen sowie die Veränderungen der Ausgangsparameter und die Änderungen in den beiden Gruppen wurden retrospektive untersucht. Die Korrelationsanalyse wurde verwendet, um Faktoren zu identifizieren, die die Myopieprogression beeinflussen könnten.

Ergebnisse Die Progression der Myopie war signifikant niedriger in der Gruppe der operierten als in der der nicht operierten Augen. Diese Situation war sowohl beim durchschnittlichen, jährlichen Bulbuslängenwachstum als auch beim Brillendioptrienwertewachstum ähnlich (0,21 ± 0,08 vs. 0,49 ± 0,19 mm und 0,18 ± 0,29 vs. 0,6 ± 0,33 dpt). Während der gesamten Nachbeobachtungszeit war die Verbesserung der Sehschärfe deutlicher in den operierten Augen als in den nicht operierten Augen zu sehen (0,15 ± 0,09 vs. 0,01 ± 0,1). Keine, die Myopieprogression beeinflussenden Faktoren wurde identifiziert. Schwerwiegende Komplikationen oder dauerhafte Schäden haben wir nicht feststellen können.

Schlussfolgerung Unsere Ergebnisse zeigen, dass die Skleroplastik nach Snyder-Thompson eine erfolgreiche und sichere Methode zur Verminderung oder Verhinderung des pathologischen Bulbuslängenwachstums und der damit verbundenen Zunahme der Dioptrienwerte zu sein scheint. So kann die spätere Entstehung der myopen Degeneration, welche zu erheblicher, dauerhafter Sehverschlechterung führt, eingedämmt werden.

Key words

progressive high myopia - posterior scleral reinforcement - myopia control

Schlüsselwörter

progressive, hochgradige Myopie - Skleroplastik - Myopiekontrolle


Publication History

Received: 31 May 2020

Accepted: 25 October 2020

Article published online:
19 January 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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