Late results of sclera reconstructive surgery aimed at preventing the progression of myopic macular dystrophies

Purpose To assess the long‐term efficiency of scleroplasty performed using a simplified technique of buckling the posterior pole in patients with congenital myopia complicated by macular dystrophy and posterior staphyloma of the sclera Methods The surgery was performed according to Snyder–Thompson technique in which the buckle made of a biologically active synthetic graft was sutured using a simplified technique of its localization at the posterior pole. 42 surgeries were administered to 34 patients aged 13–43 with myopia of –11.5 to –31.0 D. The shape and stage of staphyloma was determined by ultrasound scanning or with an ophthalmoscope. The follow‐up period reached 3‐8 yrs (4.2±1.3 yrs). Results Next day after surgery, flattening of the staphyloma can be seen on B‐scan. The axial length becomes 1.0‐2.0 mm shorter, the acoustic density of the posterior pole of the sclera increases by 5.3 dB, visual acuity shows a 0.1‐0.3 growth, while the refraction is 1.5‐2.5 D lower. The late follow‐up results (6‐8 years) demonstrated myopia stabilization in 90.2% of cases. Myopia progression rate turned out to be half as slow as prior to the surgery, and B‐scan showed a sustainable flattening of the staphyloma. Over the whole observation period, no new pathological processes emerged in the macular area, while no existing pathological processes showed progression Conclusion Scleroplastic surgery combined with posterior pole bucking with a biologically active synthetic graft should be recommended for the treatment of high complicated myopia, the prevention of staphyloma progression, myopic macular dystrophies and vitreomacular traction syndrome.