Abstract
Purpose: :
To compare the long-term clinical efficacy of improved Snyder-Thompson posterior scleral reinforcement operation (PSRO) in the control of progressive high myopia between juveniles and adults.
Methods: :
Thirty adults (aged >18;60 eyes) and thirty juveniles (aged≤18;60 eyes) undergoing improved Snyder-Thompson PSRO were enrolled in this study. The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),refractive errors,axial lengths and intraocular pressure were collected preoperatively and postoperatively. The eyes were monitored for 5-8 years.
Results: :
The follow-up period were (6.72±2.60) years for the juvenile group and (6.54 ±1.00) years for the adult group.(1) Refractive errors: the increment from preoperative were -(1.15±1.11)D in the juvenile group and -(0.89±0.87)in the adult group.Though there was notable difference within groups(P=0.0000), no significant difference was seen between groups(P=0.0611).In the juvenile group, 40% of eyes (24/60)had increments not more than -1D and 16.67%(10/60)experienced decrease in refractive errors postoperatively. In the adult group, 36.67% of eyes (22/60)had increments not more than -1D and 13.33%(8/60)had experienced decrease in refractive errors postoperatively. None demonstrated an increment more than -4.0D.(2) Axial lengths: the mean axial length for the juvenile group was(27.69 ±2.34)mm preoperatively with an increment of (1.07±0.66)mm postoperatively,while the mean axial length for the adult group was(29.91 ±1.95)mm preoperatively with an increment of (0.65±0.56)mm postoperatively. Both groups experienced significant increase postoperatively (P=0.0000) and notable difference was observed between groups(P=0.0002). Fifty-five percent (33/60) in the juvenile group had increments not more than 1.0mm, much lower than the adult group which showed a rate of 71.67% (43/60).No one had an increment more than 3.0mm.(3)BCVA: the BCVA was improved significantly by(0.24±0.21) in the juvenile group(P=0.0000). However, slight improvement of (0.02±0.08)was noted in the adult group(P= 0.3133) after the operations, The juvenile group compared favorably to the adult(P=0.0000). 86.67% of eyes (52/60) had an increase more than one line from pre-surgery in the juvenile group,compared with 23.33%(14/60) in the adult group. More significant improvement was seen in the juvenile group(P=0.000).
Conclusions: :
Long-term efficacy of improved Snyder-Thompson PSRO in the control of progressive high myopia in the juvenile was superior to that of the adult.
Keywords: myopia • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • sclera