| High myopia,is myopia with equal to or more than 6.0 diopers(D).Continuous lengthening of optic axis in high myopia leads to increasing of myopia which can cause irreversible damage to visual acuity because of choroidal neovascularization,macular repeatedly hemorrhage,atrophy and degeneration and retinal detachment.There is about 1%of high myopia all over the world in the myopia and the ratio is higher in China,Japan and so on in the east asia oriental.In recent years,all kinds of popular refractive surgeries,such as PRK,LASIK,and the lens surgery are symptomatic therapies.Although they can decrease the refractive degree of the operated eyes,none of these can prevent myopia from progression or the complications at the fundus of the high myopia eyes.Etiological treatment is aimed at preventing occurrence and development of the myopial,controlling the length of optic axis.In the study,we retrospectively assessed the long-term(more than ten years)safety and efficiency of scleral reinforcement after Snyder and Thompson surgery,particularly,evaluated the effect of preventing myopial choroidal neovascularization after scleral reinforcement.Objective:Of the study was,to retrospectively assess the long-term(more than ten years)safety and efficiency of scleral reinforcement after Snyder and Thompson surgery.Mothods:There were 16 patients with high myopia(32 eyes) in the study after Snyder and Thompson surgery more than ten years(range:10-13 years,mean:11.2±0.91 years) nonselectively,including 10 females(20 eyes),6 males(12 eyes).Mean age was 32.4±10.8 years old(range:11-46),mean optic axis was 29.3±2.4mm (range:25.0-33.4mm),diopter from -6.0D—-27.0D.There fundus were evaluated through slitlamp,fundus-lens,fundus fluorescence angiography,optic coherence tomography,especially evaluated whether there were choroidal neovascularization in their fundus.Their naked visual acuity,best corrected visual acuity,diopter,optic axis were evaluated preoperatively and postoperatively.There were 110 patients with high myopia(209 eyes) more than ten years in the study never after Snyder and Thompson surgery nonselectively,including 67 females(143 eyes),33 males(66 eyes).Mean age was 34.1±10.2 years old(range:18—65),mean optic axis was 28.7±2.6mm(range:25.0-33.5mm),diopter from -6.0D—-28.0D.There fundus were evaluated through through slitlamp,fundus-lens,fundus fluorescence angiography,optic coherence tomography.Statistical method:The t-test was applied to compare the axis oculi,diopter,naked vision and best corrected visual acuity perioperatively.The chi square analysis was applied to compare the incidence rate of choroidal neovascularization with operation group and non- operation group.The SPSS13.0 software was applied to analysis.Results:There was only one eye(1/32,3.1%) found choroidal neovascularization in the 16 patients with high myopia(32 eyes) in the study after Snyder and Thompson surgery more than ten years,and the others' myopial fundus were stable.There were 32 eyes(32/209,18.5%) found choroidal neovascularization in the 110 patients with high myopia(209 eyes) never after Snyder and Thompson surgery.There was statistic difference(P＜0.05) between two groups.The average optic axial preoperatively was 29.28±2.41mm in the patients after Snyder and Thompson surgery,the average optic axial postoperatively was 29.93±2.78mm,there was statistic difference(P＜0.05) between preoperation and postoperation after after Snyder and Thompson surgery more than 10 years.The average optic axia had been growed 0.643±0.661mm,and growed 0.056±0.058mm every year after surgery,there no was statistic difference(P＞0.05) with the diopers and best corrected visual acuity in the patients between preoperation and postoperation after after Snyder and Thompson surgery more than 10 years,there was statistic difference(P＜0.05) with the naked visual acuity in the patients between preoperation and postoperation after after Snyder and Thompson surgery more than 10 years.There was no obvious complications after Snyder and Thompson surgery more than 10 years.Conclusions:Scleral reinforcement is an long-term effective and safe surgery,that can stabilize the progression of high myopia.Its long-term effects hinted the surgery can prevent high myopia from the choroidal neovascularization. |
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