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Results for “Scleral Buckling”

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At least 19 recordsLinked to original sources
PubMed2003

Comparison of scleral buckling with combined scleral buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks.

BACKGROUND: The purpose of the present paper was to compare the techniques of conventional scleral buckling and combined pars plana vitrectomy and scleral buckling procedures in rhegmatogenous retinal detachments with unseen retinal breaks. METHODS: Forty-four consecutive eyes with uncomplicated, primary rhegmatogenous retinal detachments with a clear media and unseen retinal breaks were randomized to two groups. The scleral buckling group underwent 360 degrees scleral buckling, cryopexy and external subretinal fluid drainage. In the combined surgery group, 360 degrees scleral buckling, pars plana vitrectomy, air-fluid exchange, endolaser and injection of 14% perfluoropropane gas was done. RESULTS: At 3 months follow up the primary reattachment rate was 80% (16/20 cases) in the combined surgery group, and 70% (14/20 cases) in the scleral buckling group (P = 0.716). The visual acuity improved significantly from a preoperative median of hand movement (HM; range: HM to 6/60; similar in both the groups), to a median of 6/60 (range: perception of light to 6/18) in the combined surgery group and a median of 6/36 (range: HM to 6/18) in the scleral buckling group, the difference between the two groups not being statistically significant (P = 0.4). The number of intraoperative and postoperative complications was more in the combined surgery group. (four cases were lost to follow up and were doing well when last examined.) CONCLUSION: Conventional scleral buckling was found to be a safe and effective technique in the primary management of uncomplicated, rhegmatogenous retinal detachments with unseen retinal breaks when the media is clear.

Adolescent↗
PubMed2000

Efficacy of removal of buckle after scleral buckling surgery for retinopathy of prematurity.

UNLABELLED: BACKGROUND OR PURPOSE: A series of encouraging reports over the past decade indicate that scleral buckling (SB) surgery may lessen or eliminate vitreoretinal traction in advanced retinopathy of prematurity (ROP). The effects of SB surgery on refraction and ocular growth, however, have not been demonstrated. We investigated the effects of postoperative removal of buckle in infants whose retinas were reattached in stage 4 ROP. METHODS: Selected for study were 6 eyes of 3 patients whose retinas had been reattached by placing an encircling buckle, 2.5 mm in width, around the eye and whose buckles were subsequently removed. Axial lengths and refractive errors were compared before and after removal of the buckles. The patients were examined for at least 3 years after removal. RESULTS: There was high myopia in all eyes treated for stage 4 ROP with SB. All retinas remained attached after removal of the buckle. Although there was a variable degree of increase in axial length, myopic refractive error tended to decrease after removal of the buckle. CONCLUSIONS: There was some decrease in degree of myopia without resulting in retinal detachment or continued vitreous traction after buckle removal following SB surgery for ROP.

Device Removal↗
PubMed2003

Laser in situ keratomileusis as treatment for anisometropia after scleral buckling surgery.

Scleral buckling is an excellent procedure for retinal reattachment but can induce disabling refractive errors. Laser in situ keratomileusis (LASIK) has been proven effective for the reduction of refractive errors induced by ophthalmic surgery. We describe the case of a 53-year-old man who developed symptomatic anisometropia after placement of a scleral buckle for repair of a rhegmatogenous retinal detachment (RD). After the scleral buckling procedure, he retained excellent best corrected visual acuity but could not tolerate spectacle or contact lens correction. Thirty-four months after the scleral buckling procedure, LASIK was performed to correct myopic astigmatism with excellent refractive and functional results. This case demonstrates that LASIK may be safe and effective for the correction of refractive errors induced by RD repair.

Anisometropia↗
PubMed1997

[Modification of axial length and astigmatism by scleral buckling surgery].

BACKGROUND: Scleral buckling surgery for retinal detachment alters the shape of the globe resulting in changes of the refractive state of the eye. MATERIALS AND METHODS: In a prospective study of 52 eyes with retinal detachment we examined changes of corneal astigmatism and axial length induced by encircling buckling or segmental buckling spanning two quadrants. We compared our results with those found in literature. RESULTS: In most patients we found a shortening of the globe, rather in cases with encircling buckles than in the cases with segmental buckles (parallelly to the limbus). We also saw changes in astigmatism postoperatively in all patients. There was no statistically significant difference between patients with encircling and segmental buckles fixed parallelly to the limbus, neither in the change of axial length nor in the change of astigmatism. CONCLUSIONS: In all cases of scleral buckling procedures changes of corneal astigmatism and axial length are to be expected. So our results differ from those of other authors who did not always find a change of astigmatism. We suppose that the authors of the publications which differ from our results did not consider the change of the corneal axis by using the vector method.

Astigmatism↗
PubMed1995

Results of rhegmatogenous retinal detachment repair in cytomegalovirus retinitis with and without scleral buckling.

PURPOSE: To determine if scleral buckling is of any benefit in surgical repair of cytomegalovirus (CMV)-associated retinal detachment if combined with vitrectomy, silicone oil, and inferior midperipheral endolaser. MATERIALS AND METHODS: Twenty-two consecutive eyes with CMV-associated retinal detachments were repaired with vitrectomy and endolaser to all breaks and to the inferior midperipheral retina using silicone oil without scleral buckling (group 1, control group) between July 1987 and May 1992. Results were compared with another series of 56 consecutive eyes undergoing vitrectomy, silicone oil injection, endolaser to all breaks, and 360 degrees encircling scleral buckling (group 2, study group) between June 1992 and July 1993. RESULTS: Total retinal reattachment rates were 84% for group 1 and 86% for group 2. Rates of macular reattachment were 91% for group 1 and 91% for group 2. Mean best postoperative refracted visual acuity was 20/66 for group 1 and 20/67 for group 2. Median best postoperative refracted visual acuity was 20/74 for group 1 and 20/80 for group 2. These differences in results between the two groups were not statistically significant. Mean postoperative refractive error was +3.95 for group 1 and +4.92 for group 2. Patients who underwent surgery with the macula attached had a better postoperative visual outcome. CONCLUSION: Scleral buckling may not be necessary in CMV-related retinal detachment if repaired with vitrectomy, silicone oil, and inferior midperipheral endolaser. Elimination of scleral buckling may reduce intraoperative time, patient morbidity, and the risk of an accidental needle stick. Patients with macula-on retinal detachments also should be considered for surgery before macular detachment.

AIDS-Related Opportunistic Infections↗
PubMed1996

[Changes in axial length after scleral buckling surgery].

The eye lengthens after scleral buckling surgery for retinal detachment. We investigated the changes in axial length and refraction after scleral buckling. A total of 89 eyes from 88 patients which were all scheduled to undergo scleral buckling were included in this study. The eyes were classified into four groups based on the type of buckling procedures:1 local buckling, 2 encircling, 3 encircling with vitrectomy, and 4 encircling with local buckling. We examined the axial length of these eyes using ultrasonography, preoperatively and at 1, 3, and 6 months postoperatively. The refractive changes were also examined. Depending on the type of scleral buckling procedure employed, the eyes in Groups 2, 3, and 4 clearly lengthened, but those of Group 1 did not. The amount of axial lengthening in Groups 2, 3, and 4 was significantly greater than in Group 1 at 3 and 6 months after surgery. In the spherical equivalent, a myopic shift occurred in the eyes in Groups 2, 3, and 4, and this shift was significantly greater than in Group 1 In addition, the correlation between the extent of axial lengthening and myopic shift was significant. In conclusion, the axial length increases with a myopic shift due to encircling, whereas local buckling changed the axial length only slightly.

Adolescent↗
PubMed2004

Late-onset progressive strabismus associated with a hydrogel scleral buckle.

A hydrophilic implant for scleral buckling was developed in 1980. Advantages include softness and elasticity, no dead spaces, ability to gradually absorb and release antibiotics, and stimulating production of a fibrous capsule around the implant. Short-term fellow studies in rabbits showed no clinical or histologic complications. Long-term complications of the hydrogel scleral buckle have emerged in the las 10 years. These included fragmentation, subconjunctival bulging, intraocular erosion, migration, and restriction of extraocular movement. We recently encountered a patient with progressive restrictive strabismus beginning 8 years after retinal detachment repair with a MIRAgel (hydrogel; MIRA, Uxbridge, MA) scleral buckle. Worsening complaints of diplopia and discomfort led to strabismus surgery. Untreatable retinal detachment resulted in enucleation.

Aged↗
PubMed1998

Use of indomethacin for pain relief following scleral buckling surgery.

BACKGROUND/AIMS: Patients undergoing scleral buckling and cryotherapy suffer from mild to moderate postoperative pain. As good pain relief facilitates post-operative ocular examination, as well as patient comfort and recovery, the authors designed a prospective randomised double masked trial to evaluate the efficacy of indomethacin as a satisfactory analgesic for such patients. METHOD: Patients with a primary uncomplicated rhegmatogenous retinal detachment requiring scleral buckling and cryotherapy were randomly allocated to receive either indomethacin or placebo. A rectal suppository was administered 2 hours before surgery, followed by two capsules twice daily for 10 days. Pain relief was assessed with a linear graphic rating scale at the end of each day. Supplementary analgesia was allowed and recorded. RESULTS: 12 patients received indomethacin (group A) and 16 received placebo (group B). The extent of surgery was similar in both groups. One patient in group A, and two in group B withdrew after 3 days. The pain scores were converted to changes from the baseline (score on day 1), and the area under the curve calculated for each patient. The means of the areas were analysed with the Mann-Whitney test and showed that indomethacin caused a statistically significant reduction in pain score, both at 3 days (p = 0.04) and at 10 days (p = 0.014). There was no statistically significant difference in extra analgesic requirements between the two groups (p = 0.2). CONCLUSIONS: Indomethacin is recommended for short to medium term pain relief following scleral buckling and cryotherapy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Scleral buckling methods for rhegmatogenous retinal detachment.

Scleral buckling techniques are effective in treating most eyes with rhegmatogenous retinal detachment, and usually the final visual result is limited only by possible preexisting macular damage due to the detachment. Still, a variety of techniques are used, including exoplant or implant methods for the scleral buckle; cryotherapy, diathermy, or photocoagulation to cause the chorioretinal adhesion; and drainage or nondrainage of subretinal fluid. Also, recent development of alternative surgical techniques such as vitreous surgery and/or intraocular gas injection have raised questions about the current role of scleral buckling methods. This article reviews the principles and techniques of scleral buckling for retinal detachment and describes the methods we have found most useful.

Anesthesia, General↗