Our Summary

This study looked at the outcomes of eye surgery for strabismus (a condition where the eyes do not properly align with each other) in patients who had previously undergone surgery for retinal detachment. In retinal detachment surgery, a piece of material known as a scleral explant (EX) is often used, and it can either be left in the eye or removed afterwards.

The researchers compared the results of strabismus surgery in those who kept the EX in the eye and those who had it removed. They looked at the success of the surgery in terms of eye alignment and whether patients still experienced double vision, as well as any complications or need for additional surgeries.

The study included 47 patients, with most of them having kept the EX in the eye. The results showed that the final eye alignment was similar for both groups. Those who kept the EX had a slightly lower average misalignment of the eyes, both before and after the strabismus surgery. The success rates for eye alignment and resolution of double vision were also similar between the two groups.

Two complications occurred in the group that kept the EX (a cyst and an exposed EX), while two cases of retinal re-detachment were found in the group that had the EX removed. The researchers concluded that good results from the strabismus surgery were achieved whether the EX was kept in the eye or not.

FAQs

  1. What is the purpose of the scleral explant (EX) in retinal detachment surgery?
  2. Does leaving the scleral explant (EX) in the eye after surgery affect the success of strabismus surgery?
  3. Were there any complications experienced by patients who kept the scleral explant (EX) in their eye after retinal detachment surgery?

Doctor’s Tip

A doctor might advise a patient undergoing scleral buckle surgery to discuss with their surgeon whether or not to keep the scleral explant (EX) in the eye after the procedure. This study suggests that both options can lead to successful outcomes in terms of eye alignment and resolution of double vision. However, it is important to be aware of the potential complications associated with keeping the EX in the eye, such as cyst formation or exposure of the EX. Patients should follow up closely with their doctor after surgery to monitor for any complications and address them promptly if they arise.

Suitable For

Patients who have previously undergone retinal detachment surgery and have strabismus (misalignment of the eyes) may be recommended scleral buckle surgery. This type of surgery may be recommended for patients who have a history of retinal detachment and require additional eye surgery for conditions such as strabismus.

Timeline

Overall, the timeline for a patient before and after scleral buckle surgery may look something like this:

Before Surgery:

  • Patient is diagnosed with retinal detachment and recommended for scleral buckle surgery
  • Pre-operative appointments and tests are conducted to prepare for surgery
  • Surgery is scheduled and patient is informed of the procedure, risks, and benefits

During Surgery:

  • Scleral buckle surgery is performed to reattach the retina using a silicone band or sponge
  • Surgery typically lasts a few hours and is done under local or general anesthesia
  • In some cases, a vitrectomy may also be performed to remove any fluid or scar tissue from the eye

After Surgery:

  • Patient is monitored closely for any signs of complications such as infection or increased eye pressure
  • Eye patch may be worn for a few days to protect the eye and promote healing
  • Follow-up appointments are scheduled to check the progress of the eye and adjust any medications as needed
  • Vision may be blurry or distorted initially, but should improve over time as the eye heals

Overall, the recovery process can take several weeks to months, with patients gradually regaining their vision and returning to normal activities. It is important for patients to follow their doctor’s instructions carefully and attend all follow-up appointments to ensure the best possible outcome from the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scleral buckle surgery include:

  1. What is the purpose of scleral buckle surgery and how will it help treat my retinal detachment?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery process after scleral buckle surgery and what can I expect during this time?
  4. Will I need to follow any special post-operative care instructions or restrictions after the surgery?
  5. How successful is scleral buckle surgery in preventing future retinal detachments?
  6. Are there any alternative treatment options to consider instead of scleral buckle surgery?
  7. How many scleral buckle surgeries have you performed and what is your success rate?
  8. What is the expected outcome in terms of my vision and eye alignment after the surgery?
  9. Will I need any additional surgeries or treatments in the future after scleral buckle surgery?
  10. Are there any long-term effects or considerations I should be aware of after undergoing scleral buckle surgery?

Reference

Authors: Christakopoulos CE, Larson SA, Vinding T, Buch Hesgaard H. Journal: Acta Ophthalmol. 2022 Feb;100(1):e71-e76. doi: 10.1111/aos.14888. Epub 2021 Jul 26. PMID: 34309207