| Objective:To investigate the clinical results and changes in fundus morphology after posterior scleral reinforcement for super-high myopia.Methods:Retrospective case series study.Patients with super-high myopia from May 2019to August 2020 at the Eye Hospital of Nanchang First Hospital were selected.11cases of 21 eyes with super-high myopia with posterior scleral reinforcement were selected as the surgical group A,and 8 cases of 15 eyes without any surgery were selected as the control group B.The preoperative and postoperative comparison studies were performed on the surgical group A.The best-corrected visual acuity,optic disc area,Bruch’s membrane pore area,gamma zone length,central concave distance from the temporal edge of the optic disc,eye axis,retinal thickness,choroidal thickness,scleral thickness,and myopia-associated retinopathy were observed at a mean follow-up of 30 months.Results:Part I:The mean age of the two groups A and B was(25.04±9.89)and(26.20±10.20)years;the mean eye axis was(29.99±2.17)mm and(29.16±2.02)mm;the mean follow-up time was(30.04±5.51)m and(30.33±9.61)m;the differences were not statistically significant between the two groups(t=-0.30,1.25,-0.47;p=0.76,0.21,0.63).The mean changes in eye axis were(0.38±0.34)mm and(0.25±0.23)mm,the mean changes in optic disc area were(-0.15±0.51)mm2 and(0.11±.45)mm2,and the mean changes in Bruch’s membrane pore area were(0.33±0.72)mm2 and(0.83±1.72)mm2,in groups A and B,respectively.The differences were not statistically significant in both groups(t=1.24,-1.55,-1.03;p=0.22,0.13,0.31).The mean central retinal thickness decreases were(14.26±6.45)um and(10.01±4.92)um in groups A and B,respectively,the mean central choroidal thickness decreases were(6.10±3.36)um and(9.11±5.38)um,respectively,and the mean central scleral thickness decreases were(29.35±9.61)um and(12.45±14.28)um;The differences in retinal thickness,choroidal thickness,and scleral thickness changes were not statistically significant when comparing the two groups(t=-2.22,0.38,-0.90;p=0.63,0.62,0.36).Myopic retinopathy was aggravated in 5 eyes(23.8%)of 21 eyes in the surgical group and in 4 eyes(26.7%)of 15 eyes in the control group,and the difference was not statistically significant(x~2=0.84).Part II:The best corrected visual acuity was Log Mar4.68±0.28,4.78±0.26before and 30 months after surgery in group A;mean optic disc area was 2.99±0.96mm~2,2.84±1.12mm~2;mean Bruch’s membrane pore area was 7.79±6.65mm~2,8.12±6.76mm~2;mean gamma area length 1.39±0.64mm and 1.31±0.71mm,respectively;the distance of the central recess from the temporal edge of the optic disc was 4.59±0.74mm and 4.57±0.64mm,respectively;the differences between the above indexes were not statistically significant when compared preoperatively and postoperatively(all p>0.05).The mean postoperative eye axis was 30.49±2.39 mm,which was an increase of 29.99±2.17 mm compared to the preoperative eye axis,and the difference was statistically significant(p=0.00).The postoperative retinal thickness and choroidal thickness were thinner than before surgery,but the difference was not statistically significant(p>0.05);the postoperative scleral thickness was thinner,and the difference was statistically significant(p=0.00).myopia-related retinopathy remained stable,reduced or even disappeared in 16 of the 21 eyes,and myopia-related retinopathy appeared newly or worsened in 5 eyes.No serious complications such as retinal detachment and vitreous hemorrhage occurred after posterior scleral reinforcement.Conclusion:After posterior scleral reinforcement,the eye axis still grew,the retina,choroid and sclera became thinner,the enlargement of Bruch’s membrane hole tended to decrease,and the incidence of myopic retinopathy was relatively reduced,indicating that the fundus generally maintained its original shape,and the surgery may have reduced the intraocular pulling force to some extent. |
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