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K. Kawana, F. Okamoto, T. Hiraoka, T. Oshika; Ciliary Body Edema after Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2977.
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Purpose: After scleral buckling surgery for rhegmatogenous retinal detachment, choroidal detachment and anterior chamber shallowing may sometimes develop. It is supposed that compression by the scleral buckling induces ciliary edema and subsequent choroidal detachment, but this postulate has not been proven. The current study was conducted to quantitatively evaluate local thickness of the ciliary body and anterior chamber depth before and after scleral buckling procedure using ultrasound biomicroscopy (UBM). Methods: Subjects were 27 eyes of 26 consecutive patients undergoing scleral buckling surgery for rhegmatogenous retinal detachment (20 male and 6 female, 46.9 ± 16.5 years old). The encircling band was applied in 16 eyes, and the remaining 11 eyes underwent segmental scleral buckling alone. UBM was used to measure ciliary body thickness in eight directions and the central anterior chamber depth before and 3, 7, 14, and 28 days after surgery. The time course of changes in ciliary body thickness and anterior chamber depth was analyzed. Results: After scleral buckling procedure, choroidal detachment was detected by ophthalmoscopic examination only in 3 eyes, while UBM revealed the presence of ciliary body edema in every direction of all eyes. Ciliary body thickness reached its peak 3 days after surgery, followed by a gradual decrease thereafter. However, ciliary body thickness did not return to the preoperative level even at 28 days postoperatively. All postoperative values were significantly higher than the ciliary body thickness before surgery (p<0.05, paired t-test). Anterior chamber depth 3 days after surgery was significantly smaller than the preoperative level (p<0.01), but values were within the normal range at 7 days and thereafter. Eyes treated with encircling band showed significantly greater amount of ciliary edema than those without encircling band (p<0.005). The ciliary body in the direction of segmental buckling was found to be significantly thicker than that in the quadrant without buckling (p<0.005). Conclusions: Even without apparent choroidal detachment and shallow anterior chamber, subclinical ciliary edema existed in every direction of all eyes for at least 1 month following scleral buckling procedure. The ciliary body in the direction of scleral buckling showed even greater edema than the other areas.
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