后巩膜加固术治疗青少年病理性近视的疗效观察

摘要

AlM:To investigate the clinical effect and safety of modified Synder - Thompson posterior scleral reinforcement for pathological myopia in teenagers.METHODS:Forty eyes in 21 teenagers with pathological myopia who underwent the posterior scleral reinforcement using bovine pericardium ( PSR group ) were retrospectively studied, and at the same time 26 eyes in 13 age- and myopia-matched children who wore spectacles were analyzed as the control group. They were followed for 3a. The changes of best-corrected visual acuity, myopic diopter and axial length before and after treatments were measured and compared between the two groups.RESULTS:The mean spherical equivalent degree after 3a in PSR group was -12. 90 ± 3. 22D, and which in the control group was -13. 40 ± 1. 85D. The mean spherical equivalent degree at the end of the follow-up period in the PSR group and the control group were increased by-1. 13 ± 0. 45D and -1. 93 ± 0. 44D respectively, and the difference between the two groups was statistically significant(P<0. 01). The best-corrected visual acuity were increased by 0. 25±0. 11 and 0. 16±0. 07 respectively, and the difference between the two groups was statistically significant(P<0. 01). The increase of axial length were 0. 71 ± 0. 34 and 1. 18 ± 0. 40mm respectively, and the difference between the two groups was statistically significant(P<0. 01). There was no serious complication such as retinal detachment, anterior segment ischemia syndrome, rejection reaction and intraocular hemorrhage in the PSR group after the surgery.CONCLUSlON:Posterior scleral reinforcement surgery can not only effectively slow down high myopic axial progression and control the myopia development, but also elevate the visual acuity.%目的：：探讨对病理性近视的青少年施行改良型 Synder-Thompson式后巩膜加固术的疗效及其安全性。方法：回顾分析于我院应用牛心包膜行后巩膜加固术的病理性近视患儿21例40眼,以同期未予手术治疗的病理性近视患儿13例26眼为对照组,随访3a,比较两组的屈光度、最佳矫正视力以及眼轴长度的变化情况。结果：随访3 a 后治疗组的平均等效球镜度为-12.90±3.22D,对照组为-13.40±1.85D,两组平均等效球镜度分别增加-1.13±0.45、-1.93±0.44D,两组相比差异有显著统计学意义(P<0.01)；最佳矫正视力分别增加0.25±0.11、0.16±0.07,两组相比差异有显著统计学意义( P<0.01)；眼轴增长分别为0.71±0.34、1.18±0.40mm,两组相比差异有显著统计学意义(P<0.01)。术后无1眼出现视网膜脱离、眼前节缺血综合征、排斥反应、眼内出血等严重并发症。结论：后巩膜加固术可以安全、有效地阻止青少年病理性近视的眼轴延长、控制近视进展,并能提高视功能。