Strabismus following retinal detachment repair: A comparison between scleral buckling and vitrectomy procedures

Abstract

Purpose: We conducted a study to investigate: (1) deviations caused by retinal detachment (RD) repair; (2) correlation between visual acuity and the number of surgeries to deviation size; and (3) differences between deviations following scleral buckling (SB) and pars plana vitrectomy (PPV). Methods: A retrospective analysis of patients with persistent binocular diplopia following RD repair. Magnitude of manifest deviation (|dev|) in the primary position (PP) and position of greatest deviation (maxDev) was calculated. LogMAR acuity and number of previous vitreoretinal procedures were correlated to |dev| in both PP and maxDev. Manifest |dev| were compared between SB and PPV groups. Results: Twenty-five patients were identified. The median |dev| was 7 prism diopters (PD) in PP and 17 PD in maxDev. We found no association between number of surgeries or VA with |dev| in either the PP (r=-0.18 and r=0.08) or maxDev (r=-0.26 and r=-0.05). Twelve patients underwent PPV: median |dev| in PP 6 PD and maxDev 9 PD. In the SB group: median |dev| in PP 8 PD and in maxDev 22 PD. |dev| in PP showed no significant differences between PPV and SB (U=63, P=0.41); however, |dev| in maxDev, showed that SB have significantly greater deviations (U=36.0, P=0.02). Conclusion: We report the largest cohort of patients with symptomatic ocular motility defects following PPV. We show no association between VA or number of procedures to strabismus magnitude. Ocular deviations in maxDev are significantly greater after SB procedures. © 2011 Macmillan Publishers Limited All rights reserved.