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Refractive changes associated with scleral buckling and division in retinopathy of prematurity
D R Chow1, P J Ferrone, M T Trese
1Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Mich., USA.
Insights
Scleral buckling for retinopathy of prematurity (ROP) causes significant myopia in infants. Dividing the buckle reduces this myopia, emphasizing the need for regular eye exams to prevent vision loss.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinal Surgery
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Scleral buckling is a surgical technique used to repair retinal detachments in ROP.
- ROP management can lead to significant refractive errors in infants.
Purpose of the Study:
- To investigate refractive changes in infants with ROP undergoing scleral buckling and subsequent buckle division.
- To quantify the myopic shift induced by scleral buckling in ROP.
- To assess the refractive outcome after scleral buckle division.
Main Methods:
- Retrospective review of medical records of infants with ROP treated with scleral buckling.
- Analysis of refractive error measurements taken during and after scleral buckle division.
- Evaluation of refractive changes in seven eyes from six patients.
Main Results:
- Scleral buckling induced a mean myopia of -11 diopters (D) and anisometropia of -9.5 D.
- After buckle division, mean myopia reduced to -5.68 D, a mean reduction of 5.5 D.
- The procedure was performed at a mean postconceptional age of 48 weeks, with division at 36 weeks postoperatively.
Conclusions:
- Scleral buckling in ROP causes substantial myopic shifts.
- Division of the scleral buckle leads to a significant reduction in myopia.
- Repeated refraction testing is crucial after scleral buckle placement and division to prevent refractive amblyopia in infants.
Objective:
To examine the refractive changes that occur in infant eyes with retinopathy of prematurity (ROP) retinal detachments that are subjected to scleral buckling and subsequent division of the scleral buckle.
Methods:
A retrospective medical record review of infants with ROP who were managed with an encircling scleral buckle that was subsequently divided and who underwent refraction evaluation during and after division of the scleral buckle.
Results:
Seven eyes from 6 patients had scleral exo-plants placed for stage 4 ROP retinal detachments at a mean postconceptional age of 48 weeks. The mean refractive error in eyes with the scleral buckle was -11 diopters (D) (range, -5 to -25 D) with an induced mean anisometropia of -9.5 D. After division of the scleral buckle at a mean of 36 weeks postoperatively, the average post-scleral buckle refractive error was -5.68 D, resulting in a mean myopic reduction of 5.5 D.
Conclusions:
Scleral buckling in infants with ROP results in large myopic shifts, which are significantly reduced after division of the scleral buckle. This highlights the importance of repeated refraction testing in infants after placement and division of the scleral buckle to avoid refractive amblyopia.