Our Summary

This research paper looks at the effects of a specific type of eye surgery. People who have had a surgery to repair a detached retina (a serious eye condition where the back part of the eye peels away) often have a second operation to correct strabismus, a condition where the eyes don’t align properly. This paper looked at patients who had this second operation, with a focus on those who didn’t have a piece of material (scleral buckle) removed from their eye that was used in the first operation.

The researchers looked at medical records from 2002 to 2015 and found 23 patients who fit this description. They wanted to see how successful the second operation was in terms of motor success (how well the eyes could move) and sensory success (whether the patients stopped seeing double images).

They found that the second operation was quite successful: 74% of patients had improved eye movement and 94% stopped seeing double images. They also found that other factors like the patient’s age, how many surgeries they had, the condition of a part of the eye called the macula, how long it took them to get the second surgery, their vision in the worse eye, or how severe their strabismus was before the operation did not significantly affect the success of the surgery.

In simple terms, this study suggests that for people with strabismus after retina repair, having a second operation without removing the scleral buckle can be quite successful in improving eye movement and stopping double vision.

FAQs

  1. What is the motor and sensory success rate of strabismus surgery following scleral buckle procedure for retinal detachment without removal of the scleral buckle?
  2. Is there a significant difference in motor success rate and persistence of diplopia postoperatively in relation to various patient factors like age, number of RD surgeries, etc.?
  3. What was the average time between the RD surgery and onset of strabismus in the studied patient group?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow post-operative instructions carefully, including keeping the eye clean and avoiding activities that could put strain on the eye. It is also important to attend follow-up appointments to monitor healing and address any concerns promptly.

Suitable For

Patients who have undergone scleral buckle surgery for retinal detachment without removal of the scleral buckle and subsequently experience strabismus may be recommended for strabismus surgery. These patients may present with horizontal, vertical, or combined strabismus, as well as diplopia. Adjustable sutures may be used during the strabismus surgery to optimize outcomes. In this study, motor success (defined as horizontal deviation of ≤10Δ and vertical deviation of ≤4Δ) was achieved in 74% of patients, and diplopia improved in 94% of patients who had preoperative fusional capability. Age, number of RD surgeries, macular status, time to strabismus surgery, visual acuity, and magnitude of preoperative deviation did not significantly affect the success rate of strabismus surgery in these patients.

Timeline

  • Patient undergoes scleral buckle surgery for retinal detachment
  • Patient experiences onset of strabismus on average 11.05 months after RD surgery
  • Patient may present with horizontal, vertical, or combined strabismus
  • Patient may experience diplopia
  • Adjustable sutures may be used in strabismus surgery
  • Final motor surgical success achieved in 74% of patients
  • Diplopia improved in 94% of patients with preoperative fusional capability
  • No significant differences in age, number of RD surgeries, macular status, time to strabismus surgery, visual acuity, or magnitude of preoperative deviation with regard to motor success and persistence of diplopia postoperatively.

What to Ask Your Doctor

  1. What is scleral buckle surgery and why is it necessary for retinal detachment repair?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery process after scleral buckle surgery?
  4. Will I need additional surgeries or treatments after the scleral buckle surgery?
  5. Will the scleral buckle affect my vision or eye movement in any way?
  6. What are the chances of developing strabismus (eye misalignment) after scleral buckle surgery?
  7. How soon after the scleral buckle surgery can strabismus surgery be performed?
  8. What are the success rates of strabismus surgery following scleral buckle surgery?
  9. Will the strabismus surgery improve my double vision (diplopia) and eye alignment?
  10. Are there any specific precautions or post-operative care instructions I should follow after strabismus surgery with a scleral buckle in place?

Reference

Authors: Osigian CJ, Rothfield L, Rabina G, Cavuoto KM, Spierer O, Vanner EA, Capo H. Journal: J AAPOS. 2018 Aug;22(4):272-275.e1. doi: 10.1016/j.jaapos.2018.04.004. Epub 2018 Jul 6. PMID: 29981929