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J. P. Shulman, G. Landa, L. Spielberg, T. Muldoon, R. Rosen; Retinal Functional Imaging for Evaluating Blood Flow After Encircling Scleral Buckles. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2299.
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To evaluate the effect of an encircling scleral buckle on retinal blood flow in eyes that underwent rhegmatogenous retinal detachment (RRD) repair using the Retinal Functional Imager (RFI).
Twelve patients underwent retinal functional imaging of both eyes - the eye that had a RRD repair with an encircling scleral buckle and the un-operated fellow eye, serving as the control. The RFI is a novel non-invasive imaging system which allows for quantitative analysis of retinal blood flow. The main outcome measures were arterial and venous velocities in the posterior pole.
There were five females and seven males. All had RRD repairs with an encircling buckle. In 75% (9 out of 12 patients), both arterial and venous velocities were found to be lower in the buckled eye as compared to the un-operated fellow eye. The average time after surgery of these nine patients was 16.6 months (range 2 - 58 months). In 16.7% (2 out of 12 patients), higher arterial and venous velocities were measured in the operated eye. The average time after surgery of these patients was 38.8 years (range 23.7 to 54 years). One patient had higher venous but not arterial velocity in the fellow eye.
The preliminary results of this study show that scleral buckling affects the arterial and venous blood flow in the posterior pole, perhaps due to the constrictive effect on the retinal vasculature of the encircling band. This may contribute to decreased visual acuity after scleral buckling despite excellent anatomic outcome and may explain the slow, gradual improvement in vision in patients who underwent scleral buckles. This constrictive effect appears to resolve many years after the surgery, as the blood flow velocity in older buckles appears to normalize, and even be higher than the fellow un-operated, eye.
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