Cataract Outcomes Following Scleral Buckle Surgery for Retinal Detachment.

Area of Science:

• Ophthalmology
• Retinal Surgery
• Cataract Surgery

Background:

• Scleral buckling (SB) is a common surgical procedure for retinal detachment (RD).
• Cataract formation is a known complication following SB surgery.
• Assessing outcomes of cataract surgery in patients with a history of SB is crucial for managing their visual health.

Purpose of the Study:

• To evaluate the refractive, visual, and safety outcomes of cataract surgery performed after scleral buckling for retinal detachment.
• To compare the accuracy of different intraocular lens (IOL) calculation formulas in eyes that have undergone prior SB surgery.
• To identify the incidence of complications after cataract extraction in this patient population.

Main Methods:

• A retrospective chart review was conducted at an academic medical center.
• Included were eyes with a history of SB followed by cataract extraction between 2010 and 2022.
• Exclusion criteria included short follow-up, silicone oil presence, prior corneal surgery, or other pathologies. Refractive prediction was performed using Barrett Universal II, Kane, and SRK/T formulas. Complications within one year were recorded.

Main Results:

• Sixty eyes were included; 40 had postoperative refraction data. Mean absolute prediction errors were 0.49D (BU2), 0.45D (Kane), and 0.52D (SRK/T).
• Over 90% of eyes had refractive outcomes within 1.0D of predicted values with all formulas. Visual acuity outcomes were favorable in both macula-on and macula-off RD eyes.
• Posterior capsular opacification was the most common complication, occurring in 56.7% of eyes, often requiring Nd:YAG capsulotomy.

Conclusions:

• Cataract surgery following scleral buckling can yield good visual results, despite potentially modest reductions in refractive outcome predictability.
• Modern IOL calculation formulas demonstrate reasonable accuracy in this challenging surgical cohort.
• Careful consideration of prior SB surgery is warranted when planning cataract extraction to optimize visual rehabilitation.