TNOA Journal of Ophthalmic Science and Research (Jan 2018)
Posterior staphyloma
Abstract
Introduction: Very high myopia is usually associated with posterior staphyloma. The pathology, management and our experience reported in the article. Methods: We studied a total of 3737 student population in schools and colleges in the year 2001 — 2002 with the help of the Principals and teachers. High myopic patients treated in our hospital (242 patients) who underwent B—Scan and surgical management in two stages, posterior scleral support operation followed by low power intraocular lens implantation, have been included in the study(14). Discussion: High myopia and keratoconus have opposite effect in the anatomy of eye ball. In high myopia, the anterior segment of the eye is usually normal or there may be slight variation in the depth of anterior chamber whereas in keratoconus the posterior segment is normal. Staphyloma, usually occurs in the posterior pole of the eye ball involving the macular region can also expand anteriorly leading to thinning of sclera to be observed as bluish bulging. As the posterior staphyloma progresses, the retina undergoes degenerative changes due to stretching in the macular region, around the ora-serrata and around the optic disc also. In the posterior pole, the thinning of sclera and retina leads to a decrease in the functional efficiency of the retina which is often misconstrued as amblyopia especially in uni-ocular high myopes. In majority of such cases, surgical compression of the posterior pole by preserved donor sclera from behind reverses the damage and restores full vision when followed by low power intra ocular lens implantation. Results and Conclusion: 242 high myopes, among which 212 patients with Bilateral and 30 patients with unilateral involvement were included in this report and final visual outcome analyzed. In the surgical management of very high myopes, it is mandatory to manage the posterior staphyloma to get good visual outcome. To arrest the myopic progression, P.S.S.O. should be performed in young age itself.
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