BACKGROUND: Partial thickness sclerectomy is the most commonly employed scleral shortening technique used in conjunction with pars plana vitrectomy in the repair of myopia-associated macular holes in patients with staphyloma. Recently, scleral shortening induced through scleral invagination has been advocated as an adjunct in retinal translocation surgery. OBJECTIVE: To determine whether a correlation exists between the amount of sclera infolding and the posttreatment reduction in axial length (AL) as a result of lamellar scleral resectioning or full-thickness scleral invagination. METHODS: Three groups of 10 eyes each underwent lamellar scleral resection with dissection of 6, 8, and 10 mm in height, and 1 group of 10 eyes underwent a 10-mm invagination. Presurgical and postsurgical external AL of globes with stabilized intraocular pressure was measured to +/-0.022-mm precision. RESULTS: Average (+/-SD) AL shortening following lamellar resections for 6-, 8-, and 10-mm groups were 1.50+/-0.24, 2.10+/-0.13, and 2.65+/-0.24 mm, respectively, and 2.50+/-0.23 mm for the 10-mm invagination group. Differences in AL before and after scleral shortening were found to be significantly different between dissections of different heights (P<.05), and not significantly different between the 10-mm resection and invagination groups (P>.17). The AL of each group was shortened by approximately 25% of the resection-invagination height. The relation was quasilinear. CONCLUSIONS: Lamellar scleral resection and nonresected scleral invagination reduce the ocular AL. The extent of the reduction significantly correlates to the amount of removed or invaginated sclera. CLINICAL RELEVANCE: Surgical shortening of the sclera is useful in the management of several retinal disorders, but causes significant changes in AL. Arch Ophthalmol. 2000;118:965-968
BACKGROUND: Partial thickness sclerectomy is the most commonly employed scleral shortening technique used in conjunction with pars plana vitrectomy in the repair of myopia-associated macular holes in patients with staphyloma. Recently, scleral shortening induced through scleral invagination has been advocated as an adjunct in retinal translocation surgery. OBJECTIVE: To determine whether a correlation exists between the amount of sclera infolding and the posttreatment reduction in axial length (AL) as a result of lamellar scleral resectioning or full-thickness scleral invagination. METHODS: Three groups of 10 eyes each underwent lamellar scleral resection with dissection of 6, 8, and 10 mm in height, and 1 group of 10 eyes underwent a 10-mm invagination. Presurgical and postsurgical external AL of globes with stabilized intraocular pressure was measured to +/-0.022-mm precision. RESULTS: Average (+/-SD) AL shortening following lamellar resections for 6-, 8-, and 10-mm groups were 1.50+/-0.24, 2.10+/-0.13, and 2.65+/-0.24 mm, respectively, and 2.50+/-0.23 mm for the 10-mm invagination group. Differences in AL before and after scleral shortening were found to be significantly different between dissections of different heights (P<.05), and not significantly different between the 10-mm resection and invagination groups (P>.17). The AL of each group was shortened by approximately 25% of the resection-invagination height. The relation was quasilinear. CONCLUSIONS: Lamellar scleral resection and nonresected scleral invagination reduce the ocular AL. The extent of the reduction significantly correlates to the amount of removed or invaginated sclera. CLINICAL RELEVANCE: Surgical shortening of the sclera is useful in the management of several retinal disorders, but causes significant changes in AL. Arch Ophthalmol. 2000;118:965-968
Authors: Robert C Augusteyn; Bianca Maceo Heilman; Arthur Ho; Jean-Marie Parel Journal: Invest Ophthalmol Vis Sci Date: 2016-01-01 Impact factor: 4.799