Observation Of Visual Field Changes After Posterior Scleral Reinforcement In High Myopia

Myopia has become one of the main reasons of visual impairment around the world.The incidence of high myopia is also increasing year by year.The control and treatment of high myopia progression is still a world problem.Posterior scleral reinforcement is an effective operative method to control the progress of high myopia.The effect of operation is gradually accepted,but the mechanism of action has not yet been fully explored.Purpose The study mainly observes the visual field changes after posterior scleral reinforcement with high myopia,and then aims to study the mechanism of posterior scleral reinforcement.Methods We did retrospective analysis of the cases diagnosed with high myopia from September 2015 to December 2016.The criteria is diopter ≥-10.00 D,axial length ≥27.0mm.The cases with single-eyes posterior scleral reinforcement,without operative treatment performed on the fellow eyes,and also containing the complete clinical data were analyzed.58 cases,including 21 males and 37 females aged from 18 to 60 years old were analyzed.The parameters such as diopter,best corrected visual acuity,axial length,and visual field were analyzed 3 weeks,3 months and 1 year after operation,respectively.Besides,The mechanism of posterior scleral reinforcement was studied.Statistical analysis The SPSS22.0 statistical software was performed to analyze the data,and the data was expressed as(?x ± s).Each set of data was first tested for normal distribution of K-S.The data meeting normal distribution was analyzed by paired t-test.If not,the data was then performed the Wilxcon ranks sum test.P<0.05 was considered statistically significant.Results 1 Diopter(spherical equivalent)changes Operative eyes: There was no significant difference between the 3 weeks,3 months and 1 year postoperation compared with the related parameters of pre-operation(P>0.05).The number of postoperative refractive errors did not change significantly.Fellow eyes: There was no significant difference between 3 weeks post operation and pre-operation(P>0.05).The data 3 months,1 year postoperation were compared with that of pre-operation and the difference was statistically significant(P<0.05).What’s more,diopters in this group continued to increase.2 Best corrected visual acuity changes Operative eyes: There was no significant difference between the 3 weeks,3 months,and 1 year after operation compared with pre-operation(P>0.05).The diopter of postoperative refractive errors did not change significantly.Fellow eyes: There was no significant difference between the three weeks postoperation and pre-operation(P>0.05).3 months and 1 year postoperation were compared pre-operation,the difference was statistically significant(P<0.05).Diopters in this group was still increasing.3 The axial length changes Operative eyes: There was no significant difference between postoperation 3 weeks,3 months and 1 year compared with pre-operation(P>0.05).There was no significant change in axial length postoperation in this group.Fellow eyes: There was no significant difference between 3 weeks,3 months postoperation and pre-operation(P>0.05).1 year postoperation were compared with pre-operation,the difference was statistically significant(P<0.05).The axial length of this group was still increasing.4 Visual field changes(MD)Operative eyes: There was a statistically significant difference between 3 weeks postoperation compared with the related parameters of pre-operation(P<0.05).There was no significant difference between the 3 months postoperation and pre-operation(P>0.05).There was a significant difference between 1 year postoperation and pre-operation(P<0.05).It was found that the MD decreased first and then increased.This shows that the visual field defect in this group was aggravated first and then improved.Fellow eyes: there was no significant difference between the 3 weeks,3 months and 1 year postoperation compared with the related parameters of pre-operation(P>0.05).There was no significant change in the visual field in this group.Conclusion 1.Posterior scleral reinforcement is an effective surgical method to prevent the progression of high myopia;2.Posterior scleral reinforcement can effectively improve the visual field of high myopia.