A Prospective Study of Biometric Stability After Scleral Buckling Surgery

Abstract

To assess time to stabilization and factors associated with changes in biometric parameters after scleral buckling (SB). Prospective case series. Seventeen eyes with primary rhegmatogenous retinal detachment (RRD) that underwent SB at the Singapore National Eye Centre were enrolled. SB surgery was performed using an encircling element and segmental buckle. Axial length (AL); anterior chamber depth (ACD), defined as the distance from the corneal epithelium to the anterior lens surface; anterior/posterior corneal curvature (K); and refraction were measured preoperatively and at week 1 and months 1, 3, 6, 9, and 12 postoperatively. Stability of each parameter was defined as the earliest time point at which there is no significant difference compared to its value at month 12. AL increased (26.09 ± 1.46 to 26.51 ± 1.96, P= .01), ACD decreased (3.84 ± 0.47 to 3.32 ± 0.57, P < .001), and a myopic shift of 1.04 diopters (95% CI 0.03-2.05, P= .04) occurred at month 12. Anterior/posterior K were not significantly changed from baseline. AL stabilized at month 3 while ACD and spherical equivalent (SE) stabilized at week 1. Cryotherapy was associated with greater increase in AL (P= .001) and myopic shift (P= .02). More extensive segmental buckling was associated with greater increase in AL (P=.009) and myopic shift (P= .03). Our study suggests that patients requiring cataract surgery after SB should have biometry performed no earlier than 3months post SB surgery, and intraocular lens power calculation with a fourth-generation formula. A greater increase in AL and myopic shift was associated with cryotherapy and more extensive segmental buckling.