Development of scleral shortening with less corneal astigmatism

Research Project

Project/Area Number	18K09403
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 56060:Ophthalmology-related
Research Institution	Shiga University of Medical Science
Principal Investigator	ohji Masahito 滋賀医科大学, 医学部, 教授 (90252650)
Co-Investigator(Kenkyū-buntansha)	澤田修滋賀医科大学, 医学部, 講師 (00378465) 柿木雅志滋賀医科大学, 医学部, 講師 (80531516) 小幡峻平滋賀医科大学, 医学部, 医員 (90814848)
Project Period (FY)	2018-04-01 – 2021-03-31
Project Status	Completed (Fiscal Year 2020)
Budget Amount *help	¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000) Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000) Fiscal Year 2019: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000) Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords	黄斑円孔網膜剥離 / 強膜短縮術 / 眼軸長短縮 / 角膜乱視 / 強膜短縮 / 強度近視 / 網膜分離症 / 眼軸長 / 脈絡膜循環
Outline of Final Research Achievements	The usefulness of scleral shortening the sclera in the temporal two quadrants has been reported as a surgical option for macular hole retinal detachment or foveoschisis associated with severe myopia, but the induced strong corneal astigmatism is a significant complication. The purpose of this study was to examine the usefulness of the technique of shortening the sclera in four quadrants, aiming at a stronger effect of shortening the axial length and reducing corneal astigmatism. We quantitatively compared the effect of shortening the axial length and the degree of corneal astigmatism caused between scleral shortening in two quadrants and in four quadrants using an isolated pig eye. Compared to scleral shortening in two quadrants, scleral shortening in four quadrants has a stronger effect of shortening the axial length, causes less corneal astigmatism. Scleral shortening in four quadrants can be a surgical procedure with stronger effect and less complications.
Academic Significance and Societal Importance of the Research Achievements	強度近視に伴う黄斑円孔網膜剥離は最も難治性の網膜剥離の一つであり、強度近視に伴う網膜分離症も治療法に議論がある。強膜短縮術は比較的容易で安全な主義ではあるが、惹起される強い角膜乱視という問題があった。今回、強膜短縮を4象限に行うことにより、眼軸長の短縮効果が強いだけではなく、惹起される角膜乱視が低減されることが判明した。本日術式を臨床応用することにより、強度近視に伴う難治性の黄斑円孔網膜剥離や網膜分離症の治療成績が改善することが期待され、社会的以外は大きい。