Risk factors influencing the outcome of strabismus surgery following retinal detachment surgery with scleral buckle.
OBJECTIVE
To determine factors associated with surgical success in patients undergoing strabismus surgery after retinal detachment repair with scleral buckle.


METHODS
The medical records of consecutive patients who underwent strabismus surgery after repair of retinal detachment with scleral buckle were retrospectively reviewed. A successful "motor" outcome was defined as horizontal deviation <10(Δ) and vertical deviation <4(Δ) in the primary position; successful "sensory" outcome was no diplopia in the primary position. Various factors such as removing the scleral buckle at the time of strabismus surgery, the macula structural status, size of the preoperative deviation, presence of restriction to passive movement, and whether the eye with the scleral buckle was the operated eye were compared among groups based on motor success.


RESULTS
A total of 25 patients were included. The overall motor success rate was 72% after 1.8 ± 0.9 operations, with 62% of patients diplopia free in the primary position. Horizontal deviation <10(Δ) (P = 0.005) and minimal restriction on forced duction test were associated with motor success after the first surgery (P = 0.05). Partial or entire scleral buckle removal (n = 15) and fellow-eye surgery were not significantly correlated with motor success in our cohort. There were no retinal redetachments after scleral buckle removal.


CONCLUSIONS
A small preoperative horizontal deviation, and minimally restricted ocular rotations were associated with better results. Removing the scleral buckle did not improve results.
Jules Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles.
Ronen
R
Rabinowitz
Federico G
FG
Velez
Stacy L
SL
Pineles
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002648:Child; D005133:Eye Movements / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012591:Scleral Buckling / Q000009:adverse effects* / Q000379:methods; D013285:Strabismus / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult