The impact of different optical treatment strategies on the dynamics of refraction after minimally invasive sclero-strengthening treatment of progressive myopia in children

Purpose: a comparative study of the effect of various optical correction methods on the dynamics of refraction in children with progressive myopia after minimally invasive scleroplasty (MIS). Material and methods. A total of 58 patients (58 eyes) aged 8 to 14 years (mean 12.0 ± 0.2 years) with moderate and high progressive myopia — from 4 to 11.5 D (mean 7.7 ± 0.3 D) with the year progression gradient (YPG) from 0.5 to 1.75 D (mean 1.25 ± 0.06 D) were operated on. In all patients, visual acuity, clinical refraction, axial length of the eye and the state of the fundus were determined. For MIS, the biologically active transplant (BAT) Hitex-HG was used. Patients were divided into groups depending on the optical correction prescribed after the operation. In group 1 (17 patients), monofocal (MF) glasses used before the operation were replaced with perifocal (Perifocal-MS, PMS) or progressive glasses. In group 2 (18 patients), children used PMS or progressive glasses before and after MSP. In group 3 (16 patients), MF or soft contact lenses were used before and after the operation. In group 4 (7 patients), MF, PMS or progressive glasses used before the operation were replaced with orthokeratology lenses. The follow-up period was 1 year. Results. Comparative analysis of YPG in groups with different optical correction showed different decrease of this parameter in the postoperative period: in group 1 — 4.7 times; in group 2 — 4 times; in group 3 — 2.3 times; in group 4 — 5 times. Conclusion. The most effective treatment is a combination of MIS and optical correction with accommodation support and/or impact on peripheral retinal defocus. This approach to managing pediatric patients with progressive myopia should be a priority.

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