Posterior scleral reinforcement using genipin-cross-linked sclera for macular hole retinal detachment in highly myopic eyes

• Published in: British journal of ophthalmology Vol. 102; no. 12; pp. 1701 - 1704
• Main Authors: Zhu, Shuang-Qian, Pan, An-Peng, Zheng, Lin-Yan, Wu, Yue, Xue, An-Quan
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.12.2018
• Subjects: Adult; Aged; Axial Length, Eye - pathology; Cholagogues and Choleretics - therapeutic use; Cross-Linking Reagents; Female; Follow-Up Studies; Humans; Hypotheses; Iridoids - therapeutic use; Male; Middle Aged; Myopia, Degenerative - complications; Myopia, Degenerative - physiopathology; Ophthalmology; Retina; Retinal Detachment - diagnostic imaging; Retinal Detachment - etiology; Retinal Detachment - physiopathology; Retinal Detachment - therapy; Retinal Perforations - diagnostic imaging; Retinal Perforations - etiology; Retinal Perforations - physiopathology; Retinal Perforations - therapy; Retrospective Studies; Sclera - drug effects; Surgery; Surgical outcomes; Tomography; Tomography, Optical Coherence; Visual Acuity - physiology; treatment surgery; retina; macula
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2017-311340

Background/aimsTo investigate the surgical outcomes of posterior scleral reinforcement (PSR) using genipin-cross-linked sclera to treat macular hole retinal detachment (MHRD) in highly myopic eyes.MethodsNineteen patients with high myopia (19 eyes) with MHRD were treated sequentially with genipin-cross-linked PSR and were followed at least for 1 year after the surgery. The best corrected visual acuity (BCVA), axial length (AL), optical coherence tomography (OCT) outcomes and the complications were evaluated.ResultsMacular hole was closed in 73.7% of the eyes, foveal reattachment rate was 100%. The mean logMAR BCVA improved from 1.27±0.55 preoperatively to 0.88±0.55 postoperatively. The preoperative AL (29.88±1.97 mm) was decreased (27.73±1.84 mm) after the operation (p<0.001).ConclusionsFor at least a 1-year period of follow-up, PSR with genipin-cross-linked sclera should be considered as a preferred surgical approach to treat MHRD in highly myopic eyes, especially when foveal retinoschisis is also documented.