Management of Anisometropic Amblyopia Associated with Unilateral High Myopia in Children with Modified Posterior Scleral Reinforcement.

Abstract

Objectives The aim of the study was to investigate the effect of modified posterior scleral reinforcement (PSR) surgery combined with comprehensive amblyopia training in children with high myopia-related anisometropic amblyopia. Methods In this retrospective study, 24 eyes with high myopic amblyopia underwent modified PSR surgery and 20 eyes without surgery were recruited as control group. The best-corrected visual acuity (BCVA), cycloplegic spherical equivalent (SE) and axial length (AL) were evaluated at the beginning of the study before operation and at the three years follow-up. Results The BCVA was significantly improved (P<0.001), whilst the myopic SE elevation (P<0.001) and AL elongation (P<0.001) were significantly attenuated in the PSR group compared to the control group at 3-year follow-up. Regarding the therapeutic effect of amblyopia, the curative ratio in the PSR group was significantly superior (P<0.001). In patients with different degree of amblyopia, BCVA improvement in the PSR group was significantly larger while more significance was recorded in the severe amblyopia group. For both preschoolers (age<6) and schoolchildren (age≥6), AL growth was significantly attenuated in the PSR group (age<6: P<0.01; age≥6: P<0.05). Meanwhile in the PSR group, the improvement in BCVA was significantly higher in younger preschoolers (P<0.05), while more significance was recorded in control group. Conclusion PSR surgery combined with comprehensive amblyopia training may be an effective strategy for the treatment of high myopia-related anisometropic amblyopia.