title: The effect of scleral exoplant removal on strabismus following retinal detachment repair.
abstract: OBJECTIVE
  Scleral buckling for retinal detachment is a well-reported cause of secondary strabismus. We analyzed the effects on motility of removal of the exoplant alone to determine whether this is warranted as a separate step in the surgical management of these patients.
  
  
  METHODS
  A retrospective case series of patients who underwent scleral exoplant removal due to symptomatic strabismus development following retinal detachment repair from 2007 to 2009 was conducted. Manifest horizontal and vertical deviations were treated as vectors of a single combined deviation (|dev|). Pre- and postoperative manifest |dev| in the primary position (|dev|(pp)) and in the gaze position of maximal deviation (|dev|(max)) were analyzed.
  
  
  RESULTS
  Five patients were identified, all with symptomatic, binocular diplopia in the primary position prior to exoplant removal. Median |dev|(pp) prior to exoplant removal was 21(Δ) and following removal was 21(Δ) (P = 0.81). The median |dev|(max) prior to exoplant removal was 33(Δ) and following removal, 22(Δ) (P = 0.82). Median follow-up was 8 months. There were no cases of retinal redetachment following the exoplant removal. No patient reported any subjective improvement of their diplopia. All 5 patients went on to have strabismus surgery as a separate procedure.
  
  
  CONCLUSIONS
  Median primary position deviation was unchanged by scleral buckle removal, and Exoplant removal has minimal long-term benefit on the strabismus following scleral buckling procedures.
authors: St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors: Vicki
authors: V
authors: Wong
authors: Shivani
authors: S
authors: Kasbekar
authors: Jane
authors: J
authors: Young
authors: Theodor
authors: T
authors: Stappler
authors: Ian B
authors: IB
authors: Marsh
authors: Jonathan M
authors: JM
authors: Durnian
mesh_terms: D000328:Adult; D000368:Aged; D004172:Diplopia / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000009:adverse effects*; D013285:Strabismus / Q000209:etiology* / Q000517:prevention & control; D014792:Visual Acuity