Effects of postocular vascular hemodynamics and choroidal thickness after posterior scleral reinforcement surgery for pathological myopia

Objective To evaluate the effects of postocular vascular hemodynamics and choroidal thickness after posterior scleral reinforcement for pathological myopia. Methods From January 2012 to June 2013, 34 patients (55 eyes) were enrolled in this prospective study and underwent posterior scleral reinforcement surgery. Two years after the procedure, visual acuity, refraction and axial length were measured, as well as choroidal thickness using enhanced depth imaging optical coherence tomography (EDI-OCT) and postocular vascular hemodynamics using Doppler imagining (CDI). A paired repeated measures ANOVA was used to analyze the differences. Results There was a statistically significant improvement in postoperative best-corrected visual acuity (BCVA) at 1, 3, 6, 12 and 24 months compared with preoperative eyes (F=3.960, P 0.05). After the 1, 3, 6, 12 and 24 months observations periods, there was a statistically significant enhancement of postoperative peak systolic velocity (PSV) and end diastolic velocity (EDV) as well as a statistically significant decrease in the resistance index (RI) of the short posterior ciliary artery (SPCA) and central retinal artery (CRA) (SPCA: F=2.376, P<0.05; F=4.476, P<0.01; F=4.238, P<0.01. CRA: F=2.316, P<0.05; F=3.335, P< 0.01; F=9.770, P<0.01). Significant differences in subfoveal choroidal thickness (SFCT) were found before and after the operation (F=2.875, P<0.05). The preoperative subfoveal choroidal thickness (SFCT) was 122.4±31.9 μm, which increased to 134.4±32.9 μm at 1 month, 139.0±35.7 μm at 3 months, 136.5±33.8 μm at 6 months, 134.9±31.5 μm at 12 months, and 135.9±35.4 μm at 24 months. The differences were statistically significant (P<0.05). Conclusion Scleral reinforcement surgery can improve visual acuity, prevent refractive progression and axial length elongation, increase postocular vascular hemodynamics and choroidal thickness so as to stabilize the progression of pathological myopia. Key words: Myopia, degenerative; Tomography,optical coherence; Choroid; Hemodynamics; Posterior scleral reinforcement surgery