Posterior scleral reinforcement combined with patching therapy for pre-school children with unilateral high myopia

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Myopia Research

Background:

• Unilateral high myopia in pre-school children poses significant challenges for visual development and can lead to amblyopia.
• Current treatment strategies often involve patching therapy and refractive correction, but controlling axial elongation remains a key concern.

Purpose of the Study:

• To evaluate the efficacy of posterior scleral reinforcement (PSR) surgery in conjunction with patching therapy for managing unilateral high myopia in pre-school children.
• To assess the impact of this combined treatment on visual acuity, axial length, refractive error, and stereoscopic vision.

Main Methods:

• A randomized controlled trial involving 32 pre-school children with unilateral high myopia.
• Participants were divided into two groups: one receiving simplified PSR surgery followed by rigid gas permeable contact lens wear and patching, and a control group receiving only contact lens wear and patching.
• Outcomes including best-corrected visual acuity, axial length, refraction, and stereoscopic vision were monitored annually for three years.

Main Results:

• The PSR group demonstrated significantly higher best-corrected visual acuity compared to the control group throughout the study.
• At the three-year follow-up, a statistically significant difference in axial length was observed between the PSR group (27.38 ± 1.30 mm) and the control group (28.29 ± 0.74 mm).
• Refractive error was also significantly different at 3 years, with the PSR group at -13.13 ± 2.55 D and the control group at -15.42 ± 1.83 D. No significant difference in stereoscopic vision was noted between groups.

Conclusions:

• Posterior scleral reinforcement (PSR) surgery combined with patching therapy is effective in improving visual acuity in children with unilateral high myopia.
• This combined therapeutic approach shows potential in arresting the progression of high myopia by reducing axial elongation.
• The treatment strategy may also contribute to the management of amblyopia in affected children.