Removal Of Scleral Buckle Research Articles

Early Removal of Scleral Buckle

Purpose: To study the outcomes of early removal of segmental buckle on visual acuity, retinal status, and astigmatism. Study Design: Interventional case series Place and Duration of Study: Mayo hospital, from February 2018 to July 2018. Methods: Ten patients fulfilling the inclusion criteria were recruited. All the patients underwent segmental radial sponge with cryoretinopexy, with or without drain and intraocular gas tamponade as per need. Post-operative follow ups were at 1st week, 4th week and 6th week. Sponge was removed at 6th week after making sure that the retina was attached. Follow ups after buckle removal were planned at 1st week, 1st month and 3rd month. Improvement in VA, retinal status and astigmatism were noted. The commonest reason for the explant removal was infection followed by pain. Normality was checked through Shapiro-Wilk’s W-test and the normality criteria was met so paired sample t-test was used to assess the significance of astigmatism pre and post-surgery. Results: The average age was 32.30 ± 16.75 years (range, 03 – 61 years). Anatomical success was achieved in 100%. Visual acuity improved in all patients. Moreover, early removal of buckle reduced astigmatism and further improvement in vision was also noted. Pre and post-surgical vision improvement was statistically significant with p-value of 0.000. After removal of buckle, improvement of astigmatism was also statistically significant p-value 0.004. Conclusion: The early removal of scleral explant not only provides symptomatic relief to the patients, but is also associated with marked improvement in visual acuity was noted. Key Words: Visual Acuity, Astigmatism, Retinal Detachment, Segmental Scleral Buckle.

Strabismus surgery outcomes without removal of scleral buckle in patients with previous retinal detachment repair

To report the motor and sensory outcomes of strabismus surgery following scleral buckle procedure for retinal detachment (RD) without removal of the scleral buckle. The medical records of patients who underwent strabismus surgery without removal of scleral buckle following RD surgical repair at a tertiary referral center between 2002 and 2015 were reviewed retrospectively. Demographic data were recorded, and rates of surgical motor success (defined as horizontal deviation of ≤10Δ and vertical deviation of ≤4Δ) and sensory success (resolution of diplopia) were calculated. A total of 23 patients (mean age, 58.4±24.4years; 12 males) were included. The average time between the RD surgery and onset of strabismus was 11.05±10.95months (range, 1-42months). The strabismus was horizontal in 6 patients, vertical in 2, and combined in 15. Eighteen patients (78%) presented with diplopia. Adjustable sutures were used in 18 patients. Final motor surgical success was achieved in 17 of 23 patients (74%), and diplopia improved in 17 of 18 patients (94%) who had preoperative fusional capability. There was no statistically significant difference in age, number of RD surgeries, macular status, time to strabismus surgery, visual acuity in the worse eye, or magnitude of preoperative horizontal and vertical deviation with regard to motor success rate and with persistence of diplopia postoperatively. In our study cohort, strabismus surgery without removal of the scleral buckle resulted inmotor success and alleviated diplopia in the majority of patients with prior RD repair.

Scleral buckle removal as treatment for persistent subfoveal fluid after scleral buckle surgery for retinal detachment.

To describe the removal of scleral buckle (SB) as a potential treatment option for persistent subfoveal fluid after SB retinal reattachment surgery. Case report of a single patient. A 56-year-old man with a preoperative best-corrected visual acuity of 20/20 underwent SB surgery for a macula-on retinal detachment. Postoperatively he developed subfoveal fluid with best-corrected visual acuity ranging from 20/30 to 20/40. Nine months after the original retinal reattachment surgery, the patient underwent SB removal as a treatment for persistent subfoveal fluid and incomplete recovery of visual acuity. One week after SB removal, the subfoveal fluid was substantially diminished and best-corrected visual acuity had returned to 20/20. This case suggests that removal of SB after retinal reattachment may be a viable treatment option in patients with persistent subfoveal fluid on optical coherence tomography and incomplete recovery of preoperative visual acuity.

Complications of hydrogel explants used in scleral buckling surgery

Purpose To report a group of patients with symptoms of pain, strabismus, sensation of orbital fullness, and presence of a subconjunctival mass many years after successful scleral buckling surgery using hydrogel explants. Design We present an interventional consecutive case series of patients who underwent scleral buckling surgery using hydrogel explants from 4 to 14 years before onset of clinical symptoms. Setting This is a retrospective, multicenter clinical study. Patient population: 17 eyes of 15 patients presented with this disorder. All patients were examined; Snellen acuity, ocular motility, tonometry, slit lamp, and fundus examination were recorded. Two patients underwent either computed tomography or magnetic resonance imaging. Removal of the hydrogel explant was attempted in all patients. Removal of the buckle was technically difficult; the hydrogel material was fragile and fragmented when handled. Results All patients had prompt relief of pain and discomfort. Ocular motility and diplopia were greatly improved. Extraocular muscle surgery was not required in any case. Three eyes had intraoperative eye wall perforation. One eye developed postoperative bacterial endophthalmitis. Five eyes had recurrence of retinal detachment. One eye had additional complications of corneal edema and glaucoma. Conclusions Patients who develop this clinical condition should be considered for removal of the hydrogel scleral buckle. Early recognition of this condition may prevent serious complications associated with delayed removal.