Partial scleral buckle removal during strabismus surgery after retinal detachment repair

To describe outcomes after partial scleral buckle removal at the time of strabismus surgery.

The medical records of consecutive patients with symptomatic diplopia who underwent strabismus surgery after scleral buckling by two surgeons were reviewed retrospectively. All patients underwent forced duction testing and had a segment of the scleral buckle removed intraoperatively. Pre- and postoperative ocular motility and alignment were compared. The outcome was considered successful if residual horizontal deviation was ≤8^Δ, vertical deviation ≤2^Δ, and cyclotropia <5°.

A total of 12 patients (mean age, 51 years; range, 14-71 years) with a mean horizontal deviation of 16^Δ (range, 2^Δ-40^Δ) and mean vertical deviation of 10^Δ (range, 2^Δ-20^Δ) were included. Three patients underwent 2 strabismus surgeries. All patients underwent intraoperative removal of a segment of the scleral buckle near a muscle being advanced or recessed at the time of surgery. An adjustable suture technique was used in 13 of 15 surgeries (86%). Orthotropia was achieved in 7 patients (58%); surgical success, in 11 (92%). Subjective resolution of diplopia was achieved in all patients, in 2 with the aid of prisms. Mean follow-up was 12.4 months (range, 1-75). No patient had retinal redetachment.

In this case series, removal of a segment of the scleral buckle facilitated advancement or recession of a rectus muscle and was associated with good outcomes without retinal redetachment.