Encircling scleral buckling impact on ocular accommodation changes in patients with rhegmatogenous retinal detachment

Encircling scleral buckling is a surgical intervention employed for the purpose of visual restoration in individuals diagnosed with rhegmatogenous retinal detachment (RRD). While this particular approach is not commonly used for the purpose of enhancing accommodation, it has garnered attention in various studies. This research aimed to objectively measure accommodation changes using the iTrace device in patients with RRD who have undergone encircling scleral buckling surgery.

This pilot prospective cohort study included 40 eyes from 20 patients with RRD who underwent encircling scleral buckling surgery in one eye. The surgical group included 20 RRD eyes and the non-exposure group included 20 healthy eyes. The objective aberrometry was performed by directing a light beam at a 6-m and 20-cm distant using the iTrace. We assessed post-surgical accommodation changes within two groups using the Wilcoxon signed-rank test, quantified clinically relevant changes with the mean difference (MD), and evaluated change magnitude with the standardized mean difference (Hedges' g).

The average age of the patients was 33.9 ± 8 years, with 12 males and 8 females. Baseline accommodation for the non-operated eye measured 2.76 diopters at 20 cm and 1.37 diopters at 50 cm. At 20 cm, the non-operated and operated eyes showed mean accommodation changes of 0.2 diopters (p = 0.123) and 0.01 diopters (p = 0.949), respectively. At 50 cm, the non-operated eye changed by 0.12 diopters (p = 0.292) while the operated eye decreased by - 0.01 diopters (p = 0.930). Overall, minor postoperative accommodation changes were observed, with no significant differences detected.

Encircling scleral buckling in RRD patients shows no significant changes observed postoperatively in either operated or non-operated eyes and the 98.75% CI suggests any potential benefit is likely too small to be clinically meaningful.