The efficacy and safety of posterior scleral reinforcement using genipin cross-linked sclera for macular detachment and retinoschisis in highly myopic eyes

• Published in: British journal of ophthalmology Vol. 100; no. 11; pp. 1470 - 1475
• Main Authors: Zhu, Shuang-Qian, Zheng, Lin-Yan, Pan, An-Peng, Yu, A-Yong, Wang, Qin-Mei, Xue, An-Quan
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.11.2016
• Subjects: Adhesives; Adult; Aged; Female; Follow-Up Studies; Humans; Iridoids - pharmacology; Male; Middle Aged; Myopia, Degenerative - complications; Myopia, Degenerative - physiopathology; Ophthalmoscopy; Refraction, Ocular; Retinal Detachment - diagnosis; Retinal Detachment - etiology; Retinal Detachment - surgery; Retinoschisis - diagnosis; Retinoschisis - etiology; Retinoschisis - surgery; Retrospective Studies; Sclera - surgery; Scleral Buckling - methods; Time Factors; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity; Macula; Retina; Treatment Surgery
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2015-308087

Background/aimsTo evaluate the efficacy and safety of posterior scleral reinforcement (PSR) using genipin cross-linked sclera as the material to treat macular detachment and retinoschisis, both without macular hole, in highly myopic eyes.MethodsTwenty-one patients with highly myopic eyes (24 eyes) with macular detachment and retinoschisis were treated sequentially with genipin cross-linked PSR and were followed for at least 1 year after surgery. The best-corrected visual acuity (BCVA), spherical equivalent (SE) power, axial length (AL), optical coherence tomography, and the complications were evaluated.ResultsThe mean SE decreased from −13.81±4.67 D preoperatively to −9.64±4.86 D postoperatively, while the improvement in the logMAR BCVA values was from 1.24±0.57 before surgery to 1.03±0.57 after surgery. The preoperative AL (29.73±2.31 mm) was decreased (28.08±2.08 mm) after the operation. The retina in 21 eyes (87.5%) was successful reattached and the macular detachment was significantly decreased in two eyes; a macular hole occurred in one eye.ConclusionsFor at least a 1 year period of follow-up, PSR with genipin cross-linked sclera was safe and effective to treat macular detachment and retinoschisis in high myopia when a macular hole was not present. The reinforcement effect tended to be stabilised and maintained for 6 months after treatment.