Efficacy of Posterior Scleral Reinforcement in Children with High Myopia: A Systematic Review and Meta-Analysis

Abstract

Purpose: The purpose of this meta-analysis is to evaluate the effect of posterior scleral reinforcement (PSR) on axial length (AL), spherical equivalents (SE) and best corrected visual acuity (BCVA) in children with high myopia. Methods: The databases PubMed, EMBASE, Wanfang Database, CNKI, CSTJ and Cochrane Library from inception to March 2021 were searched to identify the relevant studies which evaluated the efficacy of PSR for patients under 18 years old with high myopia. The main parameters include AL, SE and BCVA. Revman software version 5.3 was used to perform the statistical analyses. Results in proportion with 95% confidence interval were calculated using dersimonian-laird model. Results: 8 studies including 383 PSR treated and 281 control eyes were finally included. Our analysis indicated that PSR could slow down the increase of AL and the loss of vision loss (P<.01). However, in the subgroup with a follow-up period shorter than three years, there was no statistical difference in BCVA changes between the PSR and control groups (WMD=-0.02, 95%CI -0.07 to 0.04, P=.58, I2=0%). The BCVA changes is significant after 3 years follow up (WMD=-0.13, 95%Cl -0.21 to -0.05, P=0.007). Conclusion: PSR can benefit children in controlling the growth of AL, SE and decrease of visual acuity. 3 years after PSR may be a critical time point. Given the limitations in our study, more research with larger sample sizes and more accurate data are required to reach a firmer conclusion.