Purchase this article with an account.
F. Goezinne, E. C. La Heij, A. T. Liem, N. Bauer, F. Hendrikse; The Occurrence and Treatment of Diplopia After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment (rrd). Invest. Ophthalmol. Vis. Sci. 2010;51(13):6067.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Objectives: The incidence of diplopia after conventional scleral buckle surgery.
One of the disadvantages of scleral buckling is the chance that the patient will have postoperative diplopia by motility disorders.Materials &
In a retrospective study we analyzed all scleral buckling (SB) surgeries performed between 2001 and 2008. The study was performed with the agreement of the institutional ethics committee. We analyzed all cases with double vision, which persisted for more than 3 months after SB surgery. Patient history, scleral buckling type, and early and late postoperative complications were noted. In all treated eyes a silicone encircling element was placed beneath the rectus muscles, and a silicone grooved strip or a radial implant were used. The decision of a radial or segmental buckle was made based on the size and location of the retinal tear.
26 (2.5 %) out of the 1038 eyes that underwent SB surgery complained of persistent post-operative double vision. In 26 eyes, this was attributable to ocular motility disturbances. In 12 other eyes the diplopia was caused by a decompensated exophoria (8 eyes) or a concomitant neurologic disorder (n=4). In this series of 26 patients, no significant association was found between the occurrence of mechanical motility disorders and the location and/or type of buckle, nor with number of muscles underneath the buckle was placed.17/26 patients were successfully treated with prisms. Four other patients were treated by occlusion.
After conventional SB surgery we found diplopia due to a mechanical motility disturbance in 2.5%. In 96,2% of the cases this was related to the vertical rectus muscles. In this series, no significant association was found between the occurrence of mechanical motility disorders and the location and/or type of buckle, nor with number of muscles underneath the buckle was placed. In the majority of cases, diplopia after SB surgery can be successfully treated with prisms.
This PDF is available to Subscribers Only