Do treatments to slow myopia progression work?
MAR 10, 2014
Question:
My doctor told me that I should undergo a scleroplasty to prevent the further rising of diopter and pressure. I read about it on the Internet and it's only approved in Europe. I'm from Europe and I'm not sure if I should consider it. I also read about this other procedure called a sclerotomy. Would these procedures be beneficial for a patient with high myopia that is progressive at around one diopter annually? My IOP is 23 and I'm using Betoptic S at the moment.
Answer:
Scleral reinforcement surgery, or scleroplasty, is a procedure performed to limit the effects of pathological myopia. In pathological myopia, the eye progressively elongates causing weakening and bulging of the sclera, called a posterior staphyloma. In scleral reinforcement surgery, a band of tissue is placed behind the eye to reinforce the weak area and prevent progression of the posterior staphyloma.
Although the procedure is more common in Russia and Japan, it has fallen out of favor in the United States due to concerns over complication risk and lack of effectiveness of the procedure. There is also controversy over when the procedure should be performed to best minimize the effects of pathologic myopia. Studies such as Ward et al. (Eye 2009) have shown a benefit in limiting the progression of myopia with scleral reinforcement surgery with temporary side effects such as double vision and elevated intraocular pressure, but more studies need to be performed before the procedure can be advocated as safe and effective.