Posterior Scleral Contraction to Treat Recurrent or Persistent Macular Detachment After Previous Vitrectomy in Highly Myopic Eyes

Zheng, Linyan; Pan, An-Peng; Zhu, Siquan; Wu, Yue; Dong, Liang; Xue, Anquan

doi:10.1097/iae.0000000000002217

Cited by 6 publications

(8 citation statements)

References 31 publications

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“…The designed amount of AL shortening before surgery was the empirical value we obtained from our previous study, which would provide a useful clue to appropriate PSC in further clinical MF treatment. 17,19 In the current study, pre-op AL of P21 was longer than 30 mm and its expected AL shortening should be more than 2.5 mm, whereas intraoperative AL shortening was less than 2 mm in actual. The insufficient AL shortening may be the core reason for unrecovery in P21 at post-op 12-month.…”

Section: Discussionmentioning

confidence: 53%

Posterior Scleral Contraction to Treat Myopic Foveoschisis in Highly Myopic Eyes

Pan²,

Zhu³

et al. 2021

Retina

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To evaluate the efficacy of posterior scleral contraction to treat myopic foveoschisis (MF).Methods: The records of MF patients treated with posterior scleral contraction were reviewed. During posterior scleral contraction, a cross-linked fusiform strip from allogeneic sclera was used and designed axial length (AL) shortening amount was around 2.0$3.0 mm based on preoperative AL. The middle part of the strip was placed at the posterior pole of the eye. After few aqueous humors were released, the strip was tightened to contract posterior sclera and shorten AL. Clinical data were collected at pre-operation (op) and post-op follow-ups for 12 months.Results: Twenty-four eyes were collected.

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Section: Discussionmentioning

confidence: 53%

Posterior Scleral Contraction to Treat Myopic Foveoschisis in Highly Myopic Eyes

Pan²,

Zhu³

et al. 2021

Retina

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“…The strip material used in this study was chosen from donor sclerae and sterilised and cross-linked with genipin for increased strength and resistance to degradation, which is beneficial for the prevention of posterior scleral expansion and maintenance of long-term surgical outcomes [ 30 ]. The length and width of the strip should be pre-designed before PSR to ensure that it can completely wrap around the macula and posterior scleral staphyloma [ 5 , 11 ]. The vortex vein, optic nerve, and other important tissues should be avoided while positioning the strip to avoid disrupting the blood supply to the eye and affecting vision.…”

Section: Discussionmentioning

confidence: 99%

“…Kosei et al [ 10 ]found that eyes with PS were more likely to develop retinal vascular microfolds in the outer macular schisis, perhaps this may be related to the backward vertical force of the PS. Zhang et al [ 11 ]also considered that MTM develops due to the pulling action of posterior scleral staphyloma because the retina lacks the ductility to match the expansion of the sclera. PPV relieves the tangential and centrifugal traction forces caused by the vitreous cortex without tackling the persistently expanding posterior scleral staphyloma [ 12 , 13 ], which is the fundamental reason for its poor clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

Posterior scleral reinforcement for the treatment of myopic traction maculopathy

Wang

Shi

et al. 2022

BMC Ophthalmol

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Background This study aimed to investigate the clinical effectiveness of posterior scleral reinforcement(PSR) for the treatment of myopic traction maculopathy (MTM). Methods This was a prospective study of 32 eyes from 20 patients with MTM treated with PSR using genipin-cross-linked donor sclera. The length of the scleral strip used for the surgery was designed to be 1.5-times the axial length of the eye, whereas its width was 0.4-times the axial length of the eye. The optical coherence tomography images, spherical equivalent of refractive error, axial length, best corrected visual acuity, electroretinogram findings, and intraocular pressure of the patients were assessed postoperatively. Results The mean duration of follow-up was 17.80 ± 8.74 months. The differences between the spherical equivalent of refractive error, best corrected visual acuity, axial length, and electroretinogram findings recorded preoperatively and those measured postoperatively were statistically significant (p < 0.05). The final reduction in axial length was 1.64 ± 0.85 mm. At the end of the follow-up, optical coherence tomography showed essential foveal reattachment in 30 eyes (93.75%), partial reattachment in two eyes (6.25%), and closure of macular holes in seven eyes (77.78%). No retinal detachment, vitreous haemorrhage, or other serious complications occurred following the surgery. Conclusions Posterior scleral reinforcement with genipin-cross-linked sclera showed safe and effective outcomes for the treatment of MTM during a follow-up period of at least one year. Trial registration 11\12\2018, ChiCTR1800020012.

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“…The strip material used in this study was chosen from donor sclerae and sterilised and cross-linked with genipin for increased strength and resistance to degradation, which is bene cial for the prevention of posterior scleral expansion and maintenance of long-term surgical outcomes 23 . The length and width of the strip should be pre-designed before PSR to ensure that it can completely wrap around the macula and posterior scleral staphyloma 5,10 . The vortex vein, optic nerve, and other important tissues should be avoided while positioning the strip to avoid disrupting the blood supply to the eye and affecting vision.…”

Section: Discussionmentioning

confidence: 99%

Posterior Scleral Reinforcement for The Treatment of Myopic Foveoschisis

Wang

Xie

et al. 2021

Preprint

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Background: This study aimed to investigate the clinical effectiveness of posterior scleral reinforcement for the treatment of myopic foveoschisis.Methods: This was a prospective study of 32 eyes from 20 patients with myopic foveoschisis treated with posterior scleral reinforcement using genipin-cross-linked donor sclerae . The length of the scleral strip used for the surgery was designed to be 1.5-times the axial length of the eye, whereas its width was 0.4-times the axial length of the eye. The optical coherence tomography images, spherical equivalent of refractive error, axial length, best corrected visual acuity, electroretinogram findings, and intraocular pressure of the patients were assessed postoperatively. Results: The mean duration of follow-up was 17.80 ± 8.74 months. The differences between the spherical equivalent of refractive error, best corrected visual acuity, axial length, and electroretinogram findings recorded preoperatively and those measured postoperatively were statistically significant (p＜0.05). The final reduction in axial length was 1.64 ± 0.85 mm. At the end of the follow-up, optical coherence tomography showed essential foveal reattachment in 30 eyes (93.75%), partial reattachment in two eyes (6.25%), and closure of macular holes in seven eyes (77.78%). No retinal detachment, vitreous haemorrhage, or other serious complications occurred following the surgery. Conclusions: Posterior scleral reinforcement with genipin-cross-linked sclera showed safe and effective outcomes for the treatment of myopic foveoschisis during a follow-up period of at least one yearTrial registration:ChiCTR1800020012

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Posterior Scleral Contraction to Treat Recurrent or Persistent Macular Detachment After Previous Vitrectomy in Highly Myopic Eyes

Abstract: Posterior scleral contraction is safe and effective for recurrent and persistent macular detachment after previous vitrectomy in highly myopic eyes. The silicone oil is removed after PSC, and vision can be preserved in these refractory cases.

Cited by 6 publications

References 31 publications

Posterior Scleral Contraction to Treat Myopic Foveoschisis in Highly Myopic Eyes

Posterior Scleral Contraction to Treat Myopic Foveoschisis in Highly Myopic Eyes

Posterior scleral reinforcement for the treatment of myopic traction maculopathy

Posterior Scleral Reinforcement for The Treatment of Myopic Foveoschisis

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