Abstract: The most obvious feature of pathological myopia is the gradual increase of the eye axis and the appearance of posterior staphyloma. Posterior scleral reinforcement surgery is currently an effective surgical method for delaying or preventing axial elongation in the treatment of pathological myopia. It mainly uses reinforcement materials to cause inflammatory reactions, neovascularization, and collagen fiber proliferation in the sclera to strengthen the weak posterior sclera and prevent further increase in axial length. This surgical method has been improved on the basis of strip method, patch method, and injection method, and currently, single strip reinforcement method is still the main method. Posterior scleral reinforcement materials are mainly divided into two categories: biological and non-biological, each with its own advantages and disadvantages. Currently, artificial pericardial patches and allogeneic sclera are the main types. Although posterior scleral reinforcement surgery has significant advantages in controlling the development of high myopia, imaging examination suggests that the shape and location of staphyloma in the sclera are diverse, making it difficult for this surgery to conform to the surgical mechanism, leading to controversy over the postoperative efficacy. (Int Rev Ophthalmol, 2023, 47:  517-523)

Key words: high myopia, posterior scleral reinforcement, reinforcement materials