Abstract
Purpose: :
The incidence of ocular motility impairment in patients operated on for retinal detachment has been reported between 7 and 54%. However, surgical treatment of retinal detachments with small radial buckles in 45 patients (≤ 4 mm of diameter [1]) did not reveal any impairment of ocular motility. Vitrectomies with encircling bands ist recommended in the European SPR study for better functional results. However, no data are available about possible side effects in terms of ocular motility impairment and postoperative binocular function.
Methods: :
We prospectively examined 32 patients 5 years after pseudophakic retinal detachment surgery with vitrectomy and a 2 mm encircling band. Ocular motility was assessed with Harm’s tangent screen, and binocular functions measured with the striated glasses of Bagolini, the Lang-Test, the Titmus-test, and the TNO-test respectively
Results: :
In all eyes retina was completely reattached, one eye had a macular pucker. No eye developed secondary glaucoma. The field of binocular vision was normal in 26 of 32 patients and was impaired in 2 patients due to diplopia in upgaze in one patient and dislocated intraocular lens in a second patient. 4 patients had no binocular vision due to amblyopia (2), long standing detachment prior to surgery (1) or advanced glaucoma (1) (already before the detachment). Good stereo vision (TNO, 60" to 240") was present in 13 patients, qualitative stereo vision (480") in 7 and no stereo vision in 12 patients (long standig detachment 4, pucker 1, advanced glaucoma 2, amblyopia 3 and vertical deviation 2).
Conclusions: :
Ocular motility disorders and impaired stereo vision after surgery were not related to the retinal detachment surgery itself, but either to a long standing detachment before surgery or to an independant condition such as amblyopia or glaucoma. We conclude that the encircling band does not impair the functional results of detachment surgery in pseudophakic eyes, but rather improves the anatomic success.reference: [1] Schrader WF, Hamburger G, Lieb B, Hansen LL, Kommerell G (1995). "Motilität und Binokularfunktion nach radiärer episkleraler Plombe." Klin Mbl Augenheilk 207: 224 - 231.
Keywords: retinal detachment • binocular vision/stereopsis • strabismus