Nonsurgical and surgical methods of sclera reinforcement in progressive myopia. 1997

E S Avetisov, and E P Tarutta, and E N Iomdina, and M I Vinetskaya, and L D Andreyeva
Moscow Helmholtz Research Institute for Eye Diseases, Russia.

OBJECTIVE As shown by the clinical picture of progressive myopia, derangements in biomechanical properties of sclera may be more or less manifested. The study aims at the development of a discriminating approach to their correction. METHODS Patients with the condition were given a sclera strengthening injection, in which a dose of liquid polymeric composition is injected under the Tenon's capsule on the scleral surface. After polymerization, the composition forms over the scleral surface a layer of elastic foamed gel. RESULTS Complex experiments on 146 rabbit eyes showed that the injected material promotes collagen formation. Gradually dissolving, the gel stimulates the growth of connective tissue on the surface of the sclera, whose stress-strain parameters improve. A thorough clinical study of 240 eyes of patients aged 8-25 years with progressive 6-10 D myopia showed that the refraction remained stable in 79.6% eyes 1 year after the sclera strengthening injection and in 52.9% cases 4-9 years after the sclera strengthening injection. At the same time, fellow intact eyes have shown, respectively, 40.3% and 13.3% of myopia stabilization, and 212 untreated eyes of the control group 26.0% and 11.1%, respectively. 612 children and adolescents with high myopia and a yearly progression of over 1.0 D were subjected to a scleroplastic operation. It was found that the myopia remained stable in 95.7% cases 1 year after the operation, and in 71.9%, 7 years after the operation. If myopia progression continued after a sclera strengthening injection or scleroplasty, a second procedure was performed. Second interventions were effected on 118 eyes of 102 patients, including 42 eyes where a sclera strengthening injection followed a sclera strengthening injection, 27 eyes where scleroplasty followed a sclera strengthening injection, 31 eyes where a sclera strengthening injection followed scleroplasty, and 18 eyes on which a second scleroplasty was performed. Second interventions provide a double decrease of myopia progression rate and, in 63% of patients, stop the progression altogether. CONCLUSIONS It can be concluded that nonsurgical and surgical techniques of correcting the biomechanical properties of sclera for the treatment of progressive myopia as well as discriminative methods of determining the indications to these procedures have proven to be effective.

UI MeSH Term Description Entries
D007267 Injections Introduction of substances into the body using a needle and syringe. Injectables,Injectable,Injection
D008297 Male Males
D009216 Myopia A refractive error in which rays of light entering the EYE parallel to the optic axis are brought to a focus in front of the RETINA when accommodation (ACCOMMODATION, OCULAR) is relaxed. This results from an overly curved CORNEA or from the eyeball being too long from front to back. It is also called nearsightedness. Nearsightedness,Myopias,Nearsightednesses
D011108 Polymers Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., BIOPOLYMERS; PLASTICS). Polymer
D011205 Povidone A polyvinyl polymer of variable molecular weight; used as suspending and dispersing agent and vehicle for pharmaceuticals; also used as blood volume expander. Polvidone,Polyvidon,Polyvinylpyrrolidone,Arufil,Bolinan,Bolinan 40,Crospovidone,Dulcilarmes,Duratears Free,Enterodes,Enterodez,Hypotears,Kollidon,Lacophtal,Lacri-Stulln,Lagrifilm,Liquifilm Lagrimas,Nutrivisc,Oculotect,PVP 40,Periston,Plasdone,Polyplasdone XL,Povidone, Unspecified,Protagens,Protagent,Unifluid,Vidirakt S mit PVP,Vidisic PVP Ophtiole,Wet-Comod,Dulcilarme,Enterode,Hypotear,Polyvidons,Protagen,Unspecified Povidone
D011817 Rabbits A burrowing plant-eating mammal with hind limbs that are longer than its fore limbs. It belongs to the family Leporidae of the order Lagomorpha, and in contrast to hares, possesses 22 instead of 24 pairs of chromosomes. Belgian Hare,New Zealand Rabbit,New Zealand Rabbits,New Zealand White Rabbit,Rabbit,Rabbit, Domestic,Chinchilla Rabbits,NZW Rabbits,New Zealand White Rabbits,Oryctolagus cuniculus,Chinchilla Rabbit,Domestic Rabbit,Domestic Rabbits,Hare, Belgian,NZW Rabbit,Rabbit, Chinchilla,Rabbit, NZW,Rabbit, New Zealand,Rabbits, Chinchilla,Rabbits, Domestic,Rabbits, NZW,Rabbits, New Zealand,Zealand Rabbit, New,Zealand Rabbits, New,cuniculus, Oryctolagus
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003238 Connective Tissue Tissue that supports and binds other tissues. It consists of CONNECTIVE TISSUE CELLS embedded in a large amount of EXTRACELLULAR MATRIX. Connective Tissues,Tissue, Connective,Tissues, Connective
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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