Fig. 1.

The steps of posterior scleral reinforcement. A After eyelid opening, the conjunctiva was cut from the nasal side of the inferior rectus muscle to the conjunctiva of the superior temporal side of the external rectus muscle, at a distance of about 2–3 mm from the limbus of the cornea. B The fascia was separated, the inferior and external rectus muscles were exposed, and a traction line was placed and applied upward to the nose. C After the macular retractor exposed the inferior oblique muscle, the oblique hook was used to hook out the inferior oblique muscle completely, and the end of the inferior oblique muscle was fully separated. D A pericardial patch was placed under the inferior oblique muscle. E A pericardial patch was placed under the inferior rectus muscle. F After the pericardial patch was straightened to the back of the eyeball, the patch was observed and confirmed to be close to the sclera without wrinkles or distortion. The inferior rectus muscle was sutured nasally and fixed on the sclera, then sutured and fixed with one stitch. G The pericardial patch was passed under the external rectus muscle. After the patch was straightened, the patch was observed and confirmed to be close to the sclera without wrinkles or distortion. Suprascleral suture and fixation of the external rectus muscle were performed using one stitch. H The eyeball was pulled to the top of the nose, and the lower oblique muscle was exposed using the macular retractor. The patch was seen to be laid flat on the projection position of the macular area above the posterior sclera. The patch was observed and confirmed to be close to the sclera without wrinkles or distortion. I After removal of the traction line, the conjunctival incision was sutured in counterposition