J Korean Ophthalmol Soc.  2023 Dec;64(12):1238-1244. 10.3341/jkos.2023.64.12.1238.

Ocular Movement Disorder after Scleral Buckling Surgery in Patients with Retinal Detachment

• Lee KJ
• Sun HJ
• Choi KS
• Lee SJ
• Kim H

• KMID: 2549029
• DOI: http://doi.org/10.3341/jkos.2023.64.12.1238

Abstract

Purpose
Binocular diplopia is a primary complication that may arise after scleral buckling surgery in patients with rhegmatogenous retinal detachment. This study examined the incidence of and risk factors for binocular diplopia after scleral buckling surgery; it also evaluated the rate of strabismus surgery success in patients with diplopia.
Methods
Medical records of 417 patients who underwent scleral buckling surgery for rhegmatogenous retinal detachment at a single institution from January 2017 to June 2022 were retrospectively reviewed. Patients who experienced binocular diplopia for > 6 months were included in the diplopia group.
Results
After surgery, 22 patients (5.3%) developed binocular diplopia. There were no significant correlations of diplopia onset with buckle position (i.e., the affected muscle), cryophotocoagulation, subretinal fluid drainage, and the use of gas or oil injections. Prism therapy restored binocular single vision in three patients. Ten patients chose to undergo strabismus surgery, and one patient underwent encircling band removal. All strabismus surgery patients displayed adhesion between the buckle and extraocular muscle. After surgery, 60% of these patients regained binocular single vision.
Conclusions
Clear risk factors leading to ocular movement disorders and diplopia after scleral buckling remain undefined. If diplopia persists despite prism-based conservative treatment, strabismus surgery may offer relief.

Keyword

Diplopia, Ocular movement disorder, Scleral buckling