The incidence of myopia is increasing year by year and the trend of younger age is obvious. The situation of myopia prevention and control is very serious. The sclera is the target organ for the development of myopia. When myopia occurs and develops, the ultrastructure of the sclera tissue will undergo pathological changes, resulting in a decrease in its tensile strength, then progressive axial growth and posterior sclera expansion. Scleral collagen cross-linking can effectively increase the hardness and tensile strength of scleral tissue, which may have great potential in the prevention and control of myopia, especially pathological myopia. At present, the effectiveness of scleral collagen cross-linking technology in the prevention and treatment of pathological myopia researches are still in the stage of animal experiments, and there are a lot of controversies on the safety. The development of any new technology to ensure safety is the primary condition. A comprehensive understanding of the safety of scleral collagen crosslinking in the prevention and control of myopia can provide more basis and guidance for the further study of scleral collagen crosslinking.
Posterior Scleral Reinforcement is an important surgical procedure for the treatment of pathological myopia. Currently used reinforcement materials mainly include biological materials such as allogeneic sclera, dura mater, and bovine pericardial patches, as well as non-biological materials such as polytetrafluoroethylene and silicone rubber devices. Allogeneic sclera and dura mater, as the most commonly used materials, have well-established surgical techniques but face source limitations, restricting their widespread clinical application. Bovine pericardial patches have improved mechanical properties through cross-linking treatment; perinatal tissues (umbilical cord/amnion) possess anti-inflammatory and regenerative characteristics; and novel biological materials such as silk fibroin hydrogels show potential in animal experiments but have not yet entered clinical validation. Among non-biological materials, expanded polytetrafluoroethylene is notable for promoting tissue integration, while adjustable silicone rubber devices offer new options for complex cases. However, existing materials still have limitations in terms of availability, long-term efficacy, and complications. Except for modified bovine pericardial patches and adjustable silicone rubber devices that have entered the clinical trial stage, most new materials remain in experimental research. Future efforts should strengthen material modification and clinical translation research to address the increasingly severe challenges in pathological myopia treatment.
