Posterior scleroplasty in children with severe myopia

To assess the influence of scleral reinforcement on the evolution of severe myopia in children.

Scleral reinforcement after Thompson was performed on 251 eyes of 154 children with high myopia from 2 to 18 years of age. The main indication criteria for surgery during the period 1992-2000 included: severe myopia more than -7 Diopters and the increase in refraction more than -1 D(per year. Zenoderm (porcin skin) was the main alloplastic material used during surgery. No serious complications were observed. The following main indicators of myopia advancement were investigated on a long-term basis and evaluated: axial length, refraction, visual acuity, fundus findings and perimetry.

The positive influence of surgery on myopia advancement was observed in 100% of patients. In about 53% of operated eyes, myopia was absolutely stopped, and in about 47% of operated eyes, its advancement was considerably reduced. During 10 years of postsurgical check-up, stabilisation of myopia was achieved, the following in individual indicators: axial length--53.8% of eyes, refraction--52.9% of eyes, visual acuity--85% of eyes, fundus findings--58.6% of eyes, perimetry--59.1% of eyes. The advancement of myopia in other 47% of patients has been decreased from 1.1 D/per year before surgery to 0.1 D till 10 years after surgery.

Scleral reinforcement is an effective and safe surgery that can stabilise the progression of severe myopia in children. (Tab. 6, Fig. 7, Ref. 12.).