Our Summary

This research paper looked at the long-term effects of strabismus eye surgery, specifically the rare occurrence of scleral perforations, where the outer coating of the eye is accidentally punctured. This is hard to measure as it often occurs in young patients and can go unnoticed. The study examined patients who had undergone strabismus surgery at least 10 years prior and had no known retinal conditions. They specifically looked for signs of scarring or changes in the retina at the sites where sutures had been applied during surgery.

The study examined 71 eyes from 43 patients. The average age at the time of examination was 27 years and on average, patients had undergone 1.8 strabismus surgeries. They found that 3 of the eyes showed retinal changes at the suture sites, which suggests an overall rate of suspected perforation of 4.2% per eye and 3.6% per surgery. These three patients had no symptoms related to these changes.

The researchers concluded that while scleral perforations during strabismus surgeries can go unnoticed, especially in young children, these changes seem to have no clinical consequences over a 10-year period. However, they suggested that these changes should be noted for future eye examinations.

FAQs

  1. What is scleral perforation and how often does it occur during strabismus surgery?
  2. What are the long-term effects of scleral perforations in patients who have undergone strabismus surgery?
  3. Why is it important to note changes related to scleral perforations for future eye examinations?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative instructions carefully, including using any prescribed eye drops or medications, avoiding strenuous activities that could put pressure on the eye, and attending all follow-up appointments to monitor healing and address any concerns promptly. It is also important to report any new or worsening symptoms, such as pain, vision changes, or redness, to your doctor immediately. By following these guidelines, you can help ensure a successful recovery and minimize the risk of complications.

Suitable For

Patients who are typically recommended scleral buckle surgery are those who have retinal detachments or tears, as well as patients with severe myopia (nearsightedness) or other conditions that increase the risk of retinal detachment. Scleral buckle surgery is often recommended as a treatment to reattach the retina and prevent further vision loss.

Timeline

Before scleral buckle surgery, a patient typically experiences symptoms such as blurred vision, flashes of light, floaters, or a curtain-like shadow over their field of vision. They may undergo a comprehensive eye examination, including imaging tests such as ultrasound or optical coherence tomography, to determine the extent of the retinal detachment.

During scleral buckle surgery, the surgeon places a silicone band around the eye to indent the wall of the eye and bring the detached retina back into place. The surgery may also involve draining subretinal fluid, sealing retinal tears, or using cryotherapy to create scar tissue that helps secure the retina in place.

After scleral buckle surgery, the patient may experience some discomfort, redness, or swelling in the eye. They may need to wear an eye patch or shield for a few days to protect the eye as it heals. Follow-up appointments with the surgeon are essential to monitor the healing process and ensure that the retina remains in place.

Over time, the patient’s vision should gradually improve as the retina reattaches and heals. Some patients may require additional procedures or treatments, such as laser therapy or vitrectomy, to address any remaining issues with the retina. Regular eye exams are crucial to monitor the long-term effects of scleral buckle surgery and ensure the health of the eye.

What to Ask Your Doctor

  1. What is scleral buckle surgery and why is it recommended for my condition?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery process and what can I expect in terms of pain and discomfort?
  4. Will I need to follow any specific post-operative care instructions or restrictions?
  5. What are the chances of developing any long-term effects or complications from the surgery?
  6. Will I need any follow-up appointments or additional treatments after the surgery?
  7. How experienced are you in performing scleral buckle surgery and what is your success rate with this procedure?
  8. Are there any alternative treatment options available for my condition that I should consider?
  9. What is the expected outcome of the surgery in terms of improving my vision and overall eye health?
  10. Are there any specific signs or symptoms I should watch out for after the surgery that may indicate a complication?

Reference

Authors: Goldberg H, Blum S, Palevski D, Cohen G, Armarnik S, Wygnanski-Jaffe T, Kinori M. Journal: Indian J Ophthalmol. 2023 Feb;71(2):631-635. doi: 10.4103/ijo.IJO_3218_21. PMID: 36727375