Scleroplasty aka Scleral reinforcement

I'd like to know what is the general view of this procedure in the USA. There are studies on the web suggesting beneficial effects in most cases eg http://www.bmj.sk/2001/10202-03.PDF

Thank you.



This discussion is related to Is scleral reinforcement performed in the US?.

[John C Hagan III, MD, FACS, FAAO]

If you are talking about scleral reinformcement to prevent progression of pathologic myopia its not considered a standard treatment and is controversial. It has been discussed at length. You can use the search and archive features to read these informative discussion

JCH MD

[nickppatel]

Dr Hagan:

If you're talking about posterior pole buckling - what's the controversy?  Are there doctors who dispute its efficacy/safety?  Any links?

Thanks.

[John C Hagan III, MD, FACS, FAAO]

Yes scleral buckling posteriorly for pathologic myopia is controversial because its never been proven to work. Use the search and arachives on this page to research futher. There are many detailed discussions with references.

JCH MD

[nickppatel]

I've been following the detailed discussions on this topic, which is why I'm surprised that you say that.  Dr. Brian Ward published a paper showing posterior pole buckling's efficacy and safety over a 5-year period in EYE in the UK.  So while I understand there was some debate over traditional scleral buckling in the past, this seems to be proof that posterior pole buckling actually works to arrest myopic progression in pathologic myopia.  Do you disagree (not trying to argue, just trying to nail down why anyone would dispute Dr. Ward's results)?

Thanks

[John C Hagan III, MD, FACS, FAAO]

I do not have extensive experience with the procedure. When I ask my consultants that are experts (retino-vitreal surgeons) they do not think its helpful.

JCH MD

[nickppatel]

Well, I can't imagine that anyone has a lot of experience with it besides Dr. Ward, since he pioneered it and has at least one patent on the buckles he uses.  And I can't imagine how the consultants would know, either, since the only posterior pole buckle surgeries (of which I'm aware) are the ones Dr. Ward and his team have performed.  The results of those were positive.  Perhaps the consultants are mistaking PPB for traditional scleral buckles.....

[ysokolovski]

If anyone's interested.

I've had this operation (scleroplasty) done 23 years ago, when I was 14 years old. I had my vision dropping 1 dioptry per year. After the operation progression stopped completely and I still wear the same prescription as 23 years ago.

I was really surprised that Canadian ophthalmologists have never heard about this procedure.

-Yuri