Posterior scleral reinforcement using genipin-cross-linked sclera for macular hole retinal detachment in highly myopic eyes

Br J Ophthalmol. 2018 Dec;102(12):1701-1704. doi: 10.1136/bjophthalmol-2017-311340. Epub 2018 Mar 8.


Background/aims: To investigate the surgical outcomes of posterior scleral reinforcement (PSR) using genipin-cross-linked sclera to treat macular hole retinal detachment (MHRD) in highly myopic eyes.

Methods: Nineteen patients with high myopia (19 eyes) with MHRD were treated sequentially with genipin-cross-linked PSR and were followed at least for 1 year after the surgery. The best corrected visual acuity (BCVA), axial length (AL), optical coherence tomography (OCT) outcomes and the complications were evaluated.

Results: Macular hole was closed in 73.7% of the eyes, foveal reattachment rate was 100%. The mean logMAR BCVA improved from 1.27±0.55 preoperatively to 0.88±0.55 postoperatively. The preoperative AL (29.88±1.97 mm) was decreased (27.73±1.84 mm) after the operation (p<0.001).

Conclusions: For at least a 1-year period of follow-up, PSR with genipin-cross-linked sclera should be considered as a preferred surgical approach to treat MHRD in highly myopic eyes, especially when foveal retinoschisis is also documented.

Keywords: macula; retina; treatment surgery.

MeSH terms

  • Adult
  • Aged
  • Axial Length, Eye / pathology
  • Cholagogues and Choleretics / therapeutic use*
  • Cross-Linking Reagents*
  • Female
  • Follow-Up Studies
  • Humans
  • Iridoids / therapeutic use*
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications*
  • Myopia, Degenerative / physiopathology
  • Retinal Detachment / diagnostic imaging
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retinal Detachment / therapy*
  • Retinal Perforations / diagnostic imaging
  • Retinal Perforations / etiology
  • Retinal Perforations / physiopathology
  • Retinal Perforations / therapy*
  • Retrospective Studies
  • Sclera / drug effects*
  • Tomography, Optical Coherence
  • Visual Acuity / physiology


  • Cholagogues and Choleretics
  • Cross-Linking Reagents
  • Iridoids
  • genipin