Posters

Clinical results with scleral reinforcement: past and present

Poster Details

First Author: N. Széll HUNGARY

Co Author(s):    Z. Sohajda   A. Boross                 

Abstract Details

Purpose:

We have been performing scleral reinforcement surgery (sustentaculum sclerae) since 1992 in our Ophthalmological Department on high, progressive myopic eyes (typically those of children) that have the potential of becoming degenerative. Here we would like to introduce our results from the past 16 years with this technique.

Setting:

Ophthalmology Department, Kenézy Gyula Hospital, Debrecen, Hungary

Methods:

In all cases, we performed scleral reinforcement using the Snyder-Thompson technique. Pre- and postoperative BCVA and spectacle diopters (D) were evaluated retrospectively in all cases. In addition to this, pre- and postoperative axial length (AL) measurements have been carried out and evaluated since 2010. Performing the surgery on the fellow eye (as needed) took clear precedence over building a control group. Between 1999 and 2009, 30 eyes of 25 patients; from 2010 to 2015, 22 eyes of 13 patients were operated.

Results:

Mean age in the two groups were: 8.72±3.9 (3-19) and 12.73±4.43 (6-23.5) years; mean follow-up period: 2.62±2.01 (4-6) and 2.54±2.0 (0.5-5) years, respectively. BCVAs changed in the first group as follows: improved in 66.7%, did not change in 26.7% and got worse in 6.6%. D-changes were as follows: improvement in 50%, no change in 43.3% and deterioration in 6.7%. In the second group, mean axial length change per year was +0.09 ± 0.11 mm, mean BCVA change per year was +0.28±0.45 and mean D-change per year was -0.09±0.58 D.

Conclusions:

In cases of progressive, high myopia, the axial length changes, and – in accordance with this – the D-changes exceed normal population values: there is an average + 0.4mm AL-change and at least +1 D-change per year in such myopic eyes. According to our results, we may conclude that it is possible to stop or significantly hold back pathological AL- and D- increase by supporting the posterior sclera, thus preventing the development of myopic degenerative lesions on the fundus, which would lead to serious, permanent visual deterioration.

Financial Disclosure:

NONE