The effect of bandage scleroplasty on the hemodynamics of the posterior segment of the eye in patients with congenital and acquired myopia

Abstract

The primary surgical method for slowing the progression of high myopia, stabilizing refraction, and preventing potential fundus complications, including the development of posterior scleral staphyloma, is reinforcement of the posterior pole of the eye. Purpose . To conduct a comparative analysis of changes in ocular hemodynamics following scleral reinforcement surgery in patients with congenital and acquired myopia in the macular and optic nerve head (ONH) areas. Materials and methods . The study included 42 patients (42 eyes) aged 13.0 ± 1.8 years with progressive high myopia, divided into two groups: Group 1 — congenital myopia with a spherical equivalent of –13.5 ± 3.0 D and an axial length of 28.9 ± 1.8 mm (n = 16); Group 2 — acquired myopia with a spherical equivalent of –8.5 ± 1.5 D and an axial length of 26.8 ± 0.8 mm (n = 26). All patients underwent scleral reinforcement surgery using a modified Snyder — Thompson technique. Choroidal thickness (CT) was measured using the multimodal SLO/OCT Mirante platform (Nidek, Japan). Blood flow assessment via the mean blur rate (MBR) parameter was performed using laser speckle flowgraphy (LSFG-RetFlow, Nidek, Japan) in the macular area and ONH region preoperatively and at 1, 6, and 12 months postoperatively. Results. A significant (p ≤ 0.05) 1.4-fold reduction in choroidal thickness (CT) was revealed in patients with high congenital myopia compared to those with acquired myopia, with no differences in blood flow velocity (MBR). Patients with congenital myopia and posterior staphyloma demonstrated a significant (p ≤ 0.05) decrease in choroidal blood filling and macular blood flow. Following surgery, the positive dynamics of CT and MBR parameters were maintained longer during long-term follow-up in patients without staphyloma compared to those with staphyloma. Conclusion. Scleral reinforcement surgery had a pronounced effect on blood flow in the posterior pole of the eye in patients with congenital and acquired myopia and stimulated ONH hemodynamics only marginally and exclusively in the congenital myopia group.