Abstract
We aim to evaluate magnitudes of higher order aberrations (HOAs) from 3rdâ6th order after scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). A retrospective cross-sectional study of 19 patients with RRD who received SB (six receiving encircling SB, thirteen receiving segmental SB) was conducted. A wavefront analysis for surveying HOAs and other ophthalmic parameters were collected. Data between operated and fellow eyes, and a subgroup analysis of operated eyes, were analyzed by the MannâWhitney U test, while a generalized linear model was applied to evaluate the correlation of HOAs to best-corrected visual acuity (BCVA) and optical symptoms. BCVA in the operated eyes was significantly worse (LogMAR: 0.18 ± 0.23 versus 0.05 ± 0.07, p = 0.001). Tilt (0.32 ± 0.14 versus 0.13 ± 0.08, p = 0.004), defocus (1.78 ± 0.47 versus 1.05 ± 0.17, p = 0.019) and coma (0.43 ± 0.11 versus 0.27 ± 0.09, p = 0.016) were significantly increased after SB. All root mean square (RMS), including RMS-3, RMS-4 and total RMS, were higher in operated eyes (all p < 0.05). Regarding Zernike terms, a significant elevation of vertical coma in the operated eyes was found (p = 0.038). In addition, tilt (0.41 ± 0.10 versus 0.17 ± 0.12, p = 0.007), defocus (2.27 ± 0.58 versus 0.82 ± 0.39, p = 0.001) and coma (0.59 ± 0.17 versus 0.11 ± 0.10, p = 0.015) were higher in the segmental subgroup, whereas spherical aberration (SA) was higher in the encircling subgroup (0.22 ± 0.04 versus 0.40 ± 0.15, p = 0.024) and RMS-4 and total RMS were increased in the segmental subgroup (both p < 0.05). Besides, tilt was correlated to worse BCVA (p = 0.036), whereas all four HOAs were correlated to the presence of optical symptoms (all p < 0.05). In conclusion, SB may increase HOAs, which could be associated with unfavorable postoperative visual outcomes and subject symptoms.
Highlights
Scleral buckling (SB) is a common surgical treatments for rhegmatogenous retinal detachment (RRD), with a reattachment rate of higher than 80% after primary surgery [1,2,3]
The reason to exclude patients with astigmatism with more than 2D cylinder is to prevent the significant influence of high astigmatism on the visual performance in patients whose vision is already damaged by RRD
The RRD occurred spontaneously in 18 patients, while one patient developed the disorder after a traumatic accident
Summary
Scleral buckling (SB) is a common surgical treatments for rhegmatogenous retinal detachment (RRD), with a reattachment rate of higher than 80% after primary surgery [1,2,3]. It is not uncommon for patients to complain of a reduced quality of vision, even if the retina is reattached postoperatively and the refractive error is fully corrected by appropriate optical lenses [12]. By decomposing the ocular wavefronts into Zernike polynomials, aberrations other than defocus and astigmatism can be identified and assessed [13,14], which is an application of wavefront technology for evaluating subtle refractive errors. Higher order aberrations (HOAs) are sums of aberrations with higher than the second Zernike order that are measured by wavefront technology and may influence visual quality, with symptoms such as night myopia, diplopia, halos and glare [13,14]. Other intraocular surgeries, including trabeculectomy and cataract surgery, increase the HOAs, with a minor effect on the long-term visual quality [18,19]
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