Indications and challenges of episcleral pressurization of macula_Chinese Journal of Ocular Fundus Diseases

Authors：

 Lyu Lin , Liu Bingqian

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China;

Corresponding author：

Lyu Lin, Email: lulin@gzzoc.com

Keywords：

Editorial; Myopia, degenerative; Myopic traction maculopathy; Posterior scleral reinforcement; Macular Buckling

DOI：

10.3760/cma.j.cn511434-20220412-00213

Video：

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Pathological myopia, characterized by progressive elongation of the axial length and formation of posterior staphyloma, is accompanied by chorioretinal irreversible degeneration. It is also the focus and biggest challenge of myopia control and blindness prevention. For managing progressive early-onset pathologic myopia and myopic traction maculopathy, episcleral pressurization of macula is a practical option. It can be divided into posterior scleral reinforcement surgery and macular buckling surgery according to the presence or absence of operative top pressure ridge after surgery, both of which are different in terms of implanted materials, procedures and indications. The implanted materials, procedures and indications are different between the two. Under the background of soaring prevalence of myopia, it is necessary to modify and cautiously popularize the techniques of episcleral pressurization of macula to provide high level clinical evidence for management of pathological myopia.

Citation： Lyu Lin, Liu Bingqian. Indications and challenges of episcleral pressurization of macula. Chinese Journal of Ocular Fundus Diseases, 2022, 38(6): 436-439. doi: 10.3760/cma.j.cn511434-20220412-00213 Copy

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3.	Yan YN, Wang YX, Yang Y, et al. Ten-year progression of myopic maculopathy: the Beijing Eye Study 2001-2011[J]. Ophthalmology, 2018, 125(8): 1253-1263. DOI: 10.1016/j.ophtha.2018.01.035.
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5.	VanderBeek BL, Johnson MW. The diversity of traction mechanisms in myopic traction maculopathy[J]. Am J Ophthalmol, 2012, 153(1): 93-102. DOI: 10.1016/j.ajo.2011.06.016.
6.	Xue A, Zheng L, Tan G, et al. Genipin-crosslinked donor sclera for posterior scleral contraction/reinforcement to fight progressive myopia[J]. Invest Ophthalmol Vis Sci, 2018, 59(8): 3564-3573. DOI: 10.1167/iovs.17-23707.
7.	Snyder AA, Thompson FB. A simplified technique for surgical treatment of degenerative myopia[J]. Am J Ophthalmol, 1972, 74(2): 273-277. DOI: 10.1016/0002-9394(72)90544-2.
8.	Metlapally R, Wildsoet CF. Scleral mechanisms underlying ocular growth and myopia[J]. Prog Mol Biol Transl Sci, 2015, 134: 241-248. DOI: 10.1016/bs.pmbts.2015.05.005.
9.	Dong X, Liu J, Bu J. The efficacy of modified posterior scleral reinforcement with round scleral patches in Chinese children with high myopia[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(7): 1543-1547. DOI: 10.1007/s00417-020-04646-3.
10.	Széll N, Boross A, Facskó A, et al. Results with posterior scleral reinforcement for progressive highly myopic children in hungary[J/OL]. Klin Monbl Augenheilkd, 2021, 2021: E1(2022-04-162)[2021-01-19]. https://pubmed.ncbi.nlm.nih.gov/33465797/. DOI: 10.1055/a-1328-2586. [published online ahead of print].
11.	Chen CA, Lin PY, Wu PC. Treatment effect of posterior scleral reinforcement on controlling myopia progression: a systematic review and meta-analysis[J/OL]. PLoS One, 2020, 15(5): e0233564[2020-05-26]. https://pubmed.ncbi.nlm.nih.gov/32453804/. DOI: 10.1371/journal.pone.0233564.
12.	Qi Y, Duan AL, You QS, et al. Posterior scleral reinforcement and vitrectomy for myopic foveoschisis in extreme myopia[J]. Retina, 2015, 35(2): 351-357. DOI: 10.1097/IAE.0000000000000313.
13.	Zhu SQ, Pan AP, Zheng LY, et al. Posterior scleral reinforcement using genipin-cross-linked sclera for macular hole retinal detachment in highly myopic eyes[J]. Br J Ophthalmol, 2018, 102(12): 1701-1704. DOI: 10.1136/bjophthalmol-2017-311340.
14.	Avetisov ES, Tarutta EP, Iomdina EN, et al. Nonsurgical and surgical methods of sclera reinforcement in progressive myopia[J]. Acta Ophthalmol Scand, 1997, 75(6): 618-623. DOI: 10.1111/j.1600-0420.1997.tb00617.x.
15.	Schepens CL, Okamura ID, Braockhurst RJ. The scleral buckling procedures. Ⅰ. Surgical techniques and management[J]. AMA Arch Ophthalmol, 1957, 58(6): 797-811. DOI: 10.1001/archopht.1957.00940010819003.
16.	Ripandelli G, Coppé AM, Fedeli R, et al. Evaluation of primary surgical procedures for retinal detachment with macular hole in highly myopic eyes: a comparison [corrected] of vitrectomy versus posterior episcleral buckling surgery[J]. Ophthalmology, 2001, 108(12): 2258-2264. DOI: 10.1016/s0161-6420(01)00861-2.
17.	Cacciamani A, Lazzeri S, Rossi T, et al. Adjustable macular buckling for full-thickness macular hole with foveoschisis in highly myopic eyes: long-term anatomical and functional results[J]. Retina, 2016, 36(4): 709-716. DOI: 10.1097/IAE.0000000000000802.
18.	Liu B, Chen S, Li Y, et al. Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial[J/OL]. Acta Ophthalmol, 2020, 98(3): e266-e272[2019-11-17]. https://pubmed.ncbi.nlm.nih.gov/31736279/. DOI: 10.1111/aos.14260.
19.	Alkabes M, Burés-Jelstrup A, Salinas C, et al. Macular buckling for previously untreated and recurrent retinal detachment due to high myopic macular hole: a 12-month comparative study[J]. Graefe's Arch Clin Exp Ophthalmol, 2014, 252(4): 571-581. DOI: 10.1007/s00417-013-2497-y.
20.	Parolini B, Frisina R, Pinackatt S, et al. Indications and results of a new l-shaped macular buckle to support a posterior staphyloma in high myopia[J]. Retina, 2015, 35(12): 2469-2482. DOI: 10.1097/IAE.0000000000000613.
21.	Tang N, Zhao X, Chen J, et al. Changes in the choroidal thickness after macular buckling in highly myopic eyes[J]. Retina, 2021, 41(9): 1858-1866. DOI: 10.1097/IAE.0000000000003125.
22.	Wu J, Lu AD, Zhang LP, et al. Study of clinical outcome and prognosis in pediatric core binding factor-acute myeloid leukemia[J]. China Medical Abstracts (Internal Medicine), 2019, 40(1): 52-57. DOI: 10.3760/cma.j.issn.0253-2727.2019.01.010.

1. Dong L, Kang YK, Li Y, et al. Prevalence and time trends of myopia in children and adolescents in China: a systemic review and meta-analysis[J]. Retina, 2020, 40(3): 399-411. DOI: 10.1097/IAE.0000000000002590.
2. Marr JE, Halliwell-Ewen J, Fisher B, et al. Associations of high myopia in childhood[J]. Eye (Lond), 2001, 15(Pt 1): 70-74. DOI: 10.1038/eye.2001.17.
3. Yan YN, Wang YX, Yang Y, et al. Ten-year progression of myopic maculopathy: the Beijing Eye Study 2001-2011[J]. Ophthalmology, 2018, 125(8): 1253-1263. DOI: 10.1016/j.ophtha.2018.01.035.
4. Ruiz-Medrano J, Montero JA, Flores-Moreno I, et al. Myopic maculopathy: current status and proposal for a new classification and grading system (ATN)[J]. Prog Retin Eye Res, 2019, 69: 80-115. DOI: 10.1016/j.preteyeres.2018.10.005.
5. VanderBeek BL, Johnson MW. The diversity of traction mechanisms in myopic traction maculopathy[J]. Am J Ophthalmol, 2012, 153(1): 93-102. DOI: 10.1016/j.ajo.2011.06.016.
6. Xue A, Zheng L, Tan G, et al. Genipin-crosslinked donor sclera for posterior scleral contraction/reinforcement to fight progressive myopia[J]. Invest Ophthalmol Vis Sci, 2018, 59(8): 3564-3573. DOI: 10.1167/iovs.17-23707.
7. Snyder AA, Thompson FB. A simplified technique for surgical treatment of degenerative myopia[J]. Am J Ophthalmol, 1972, 74(2): 273-277. DOI: 10.1016/0002-9394(72)90544-2.
8. Metlapally R, Wildsoet CF. Scleral mechanisms underlying ocular growth and myopia[J]. Prog Mol Biol Transl Sci, 2015, 134: 241-248. DOI: 10.1016/bs.pmbts.2015.05.005.
9. Dong X, Liu J, Bu J. The efficacy of modified posterior scleral reinforcement with round scleral patches in Chinese children with high myopia[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(7): 1543-1547. DOI: 10.1007/s00417-020-04646-3.
10. Széll N, Boross A, Facskó A, et al. Results with posterior scleral reinforcement for progressive highly myopic children in hungary[J/OL]. Klin Monbl Augenheilkd, 2021, 2021: E1(2022-04-162)[2021-01-19]. https://pubmed.ncbi.nlm.nih.gov/33465797/. DOI: 10.1055/a-1328-2586. [published online ahead of print].
11. Chen CA, Lin PY, Wu PC. Treatment effect of posterior scleral reinforcement on controlling myopia progression: a systematic review and meta-analysis[J/OL]. PLoS One, 2020, 15(5): e0233564[2020-05-26]. https://pubmed.ncbi.nlm.nih.gov/32453804/. DOI: 10.1371/journal.pone.0233564.
12. Qi Y, Duan AL, You QS, et al. Posterior scleral reinforcement and vitrectomy for myopic foveoschisis in extreme myopia[J]. Retina, 2015, 35(2): 351-357. DOI: 10.1097/IAE.0000000000000313.
13. Zhu SQ, Pan AP, Zheng LY, et al. Posterior scleral reinforcement using genipin-cross-linked sclera for macular hole retinal detachment in highly myopic eyes[J]. Br J Ophthalmol, 2018, 102(12): 1701-1704. DOI: 10.1136/bjophthalmol-2017-311340.
14. Avetisov ES, Tarutta EP, Iomdina EN, et al. Nonsurgical and surgical methods of sclera reinforcement in progressive myopia[J]. Acta Ophthalmol Scand, 1997, 75(6): 618-623. DOI: 10.1111/j.1600-0420.1997.tb00617.x.
15. Schepens CL, Okamura ID, Braockhurst RJ. The scleral buckling procedures. Ⅰ. Surgical techniques and management[J]. AMA Arch Ophthalmol, 1957, 58(6): 797-811. DOI: 10.1001/archopht.1957.00940010819003.
16. Ripandelli G, Coppé AM, Fedeli R, et al. Evaluation of primary surgical procedures for retinal detachment with macular hole in highly myopic eyes: a comparison [corrected] of vitrectomy versus posterior episcleral buckling surgery[J]. Ophthalmology, 2001, 108(12): 2258-2264. DOI: 10.1016/s0161-6420(01)00861-2.
17. Cacciamani A, Lazzeri S, Rossi T, et al. Adjustable macular buckling for full-thickness macular hole with foveoschisis in highly myopic eyes: long-term anatomical and functional results[J]. Retina, 2016, 36(4): 709-716. DOI: 10.1097/IAE.0000000000000802.
18. Liu B, Chen S, Li Y, et al. Comparison of macular buckling and vitrectomy for the treatment of macular schisis and associated macular detachment in high myopia: a randomized clinical trial[J/OL]. Acta Ophthalmol, 2020, 98(3): e266-e272[2019-11-17]. https://pubmed.ncbi.nlm.nih.gov/31736279/. DOI: 10.1111/aos.14260.
19. Alkabes M, Burés-Jelstrup A, Salinas C, et al. Macular buckling for previously untreated and recurrent retinal detachment due to high myopic macular hole: a 12-month comparative study[J]. Graefe's Arch Clin Exp Ophthalmol, 2014, 252(4): 571-581. DOI: 10.1007/s00417-013-2497-y.
20. Parolini B, Frisina R, Pinackatt S, et al. Indications and results of a new l-shaped macular buckle to support a posterior staphyloma in high myopia[J]. Retina, 2015, 35(12): 2469-2482. DOI: 10.1097/IAE.0000000000000613.
21. Tang N, Zhao X, Chen J, et al. Changes in the choroidal thickness after macular buckling in highly myopic eyes[J]. Retina, 2021, 41(9): 1858-1866. DOI: 10.1097/IAE.0000000000003125.
22. Wu J, Lu AD, Zhang LP, et al. Study of clinical outcome and prognosis in pediatric core binding factor-acute myeloid leukemia[J]. China Medical Abstracts (Internal Medicine), 2019, 40(1): 52-57. DOI: 10.3760/cma.j.issn.0253-2727.2019.01.010.

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