Incidence of ocular motility problems following scleral buckling surgery

The incidence and severity of extraocular muscle imbalance after conventional scleral buckling surgery was determined for 70 eyes of 68 patients with primary rhegmatogenous retinal detachment. Fifty-eight eyes had circumferential silicone explants, 10 eyes had radial sponges and 2 had both. Sixty-five per cent of eyes showed some restriction of ocular motility and 72% of patients had diplopia within their field of binocular single vision (BSV). The more extraocular muscles the explant was placed under, the more directions of gaze were likely to be restricted (p = 0.032). In 84% of eyes the restrictions could be related to the position of the explant. In 87% of patients their diplopia could also be related to the position of the explant. A second retinal detachment operation is more likely to cause restricted motility and more likely to cause diplopia within the expected field of BSV (p = 0.0297).