The Long-term Clinical Observation Of Improved Snyder-Thompson Posterior Scleral Reinforcement Operation (PSRO) In The Control Of Progressive High Myopia

Purpose:Degenerative myopia is a significant cause of vision loss,yet there is no accepted way of its controlling.This study examined improved Snyder-Thompson posterior scleral reinforcement operation(PSRO) for degenerative myopia control and observed its long-term clinical results.Meanwhile,this study was to compare the difference between juvenile and adult after operation.Methods:The eyes were monitored for 5-8 years,which were divided into two groups according to the age when they were operated.The visual acuities,intraocular pressure,axial lengths,refractive errors,best corrected visual acuities,and ocular fundi condition were collected and all complications were noted.A total of 60 people (120 eyes),either juvenile group or adult group including 30 people(60 eyes),were studied.All these patients were operated at improved Snyder-Thompson PSRO.Results:(1) Axial lengths:In juvenile group,average post-op were 27.67±2.27mm, average pre-op were 28.74±2.37mm,the average growths were 1.07±0.66mm,the difference between pre-op and posr-op was statistically significant(t=2.371,P＜0.05); In adult group,average post-op were 29.90±1.97mm,average pre-op were 30.56±1.89mm,the average growths were 0.66±0.57mm,the difference between pre-op and posr-op was not statistically significant(t=0.956,P＞0.05);(2) Refractive errors:In juvenile group,average post-op were -11.13±2.97D,average pre-op were -12.29±3.01D,the average growths were -1.15±1.11D,the difference between pre-op and posr-op was statistically significant(t=2.843,P＜0.05);In adult group,average post-op were -17.35±3.78D,average pre-op were -18.25±3.70D,the average growths were -0.89±0.87D,the difference between pre-op and posr-op was statistically significant(t=2.397,P＜0.05);(3) Best corrected visual acuities:In juvenile group,average post-op were 0.35±0.18,average pre-op were 0.59±0.26, the average growths were 0.24±0.21,the difference between pre-op and posr-op was statistically significant(t=2.971,P＜0.01);In adult group,average post-op were 0.45±0.23,average pre-op were 0.48±0.14,the average growths were 0.03±0.02,the difference between pre-op and posr-op was statistically significant(t=2.234,P＜0.05); (4) Ocular fundi:No operative complications occurred at long-term post-op in both groups.By test of OCT,there were 1.67%eyes found macula hole with vitreous retraction and 1.67%eyes found macula split in adult group.By test of three mirror contact lens,there were 1.67%eyes found periphery tears retinals in juvenile group and 5%eyes found periphery tears retinals in adult group.Conclusions:Improved Snyder-Thompson PSRO could stabilize refractive degree and ocular axial length and slow down the damage of retina to progressive high myopia.This surgery would be safe at long-term post-op.And this surgery would not result in the totally same clinical results between juvenile and adult.