Effects of Scleral Buckling Without Encircling Procedures on Retrobulbar Hemodynamics as Measured by Color Doppler Imaging

Abstract

Objective:To study the effects of segmental scleral buckling without encircling procedures on retrobulbar hemodynamic conditions using color Doppler imaging. Methods:In 65 consecutive eyes of 65 patients with unilateral rhegmatogenous retinal detachment repaired by scleral buckling, we prospectively measured the blood flow velocities in the ophthalmic artery, central retinal artery, and short posterior ciliary artery using color Doppler imaging before and 2, 12, and 24 weeks after surgery. Peak systolic velocity (PSV) and end diastolic velocity (EDV) (calculated in centimeters per second) were measured using color Doppler imaging.Results: The PSV and EDV in the ophthalmic artery were not changed significantly during follow-up. The PSV and EDV in the central retinal artery were reduced temporarily at 2 weeks after surgery, but at 12 weeks after surgery had returned to presurgery levels. The PSV and EDV in the short posterior ciliary artery on both sides continued to decrease postoperatively, and the reductions became statistically significant by 24 weeks after surgery (buckled side: P=.001 for PSV and P=.002 for EDV; unbuckled side: P<.001 for PSV and P=.004 for EDV). The decreases of PSV and EDV in the short posterior ciliary artery on the buckled side were positively correlated with the subject's age (R=0.40, P=.001 for PSV; and R=0.32, P=.008 for EDV).Conclusions: Scleral buckling procedures can cause subclinical disturbance of the choroidal circulation, even if encircling procedures are avoided. Aging is one of the risk factors for the disturbance. Ophthalmol. 2005;123:950-953 Arch

Influence of Scleral Buckling Surgery with Encircling Band on Subfoveal Choroidal Thickness in Long-Term Observations

“…Although previous studies state that scleral buckling surgery reduces choroidal blood flow, the results are not consistent. Our results were similar to those of Ito and associates, who found changes in choroid circulation without returning to the baseline after scleral buckling surgery [10]. In their studies, Kimura and associates also observed the fact that the encircling band causes a reduction of choroidal blood flow [11].…”

Macular perfusion changes assessed with optical coherence tomography angiography after vitrectomy for rhegmatogenous retinal detachment

“…These findings suggested that the postoperative macular perfusion gradually recovered along with the attached and flattened retina, and there existed a degree of difference in the recovery speed between the retinal circulation and the choroidal circulation. In previous reports, the impairment of microcirculation in RRD patients had been confirmed and the normalization of microcirculation needed 6 months or even more time to be achieved after successful surgery [5,21,22]. The discrepancy of recovery speed between our findings and the previous studies might be due to the characteristics of the eyes studied, surgical procedures, measurement methods, and measured areas.…”

Evaluation of microvascular changes in the macular area of eyes with rhegmatogenous retinal detachment without macular involvement using swept-source optical coherence tomography angiography

“…Previous reports showed a relationship between RRD and vascular changes in the macular region. Ito et al 9 described a reduction in the vascular flow in the central retinal artery and the short posterior ciliary artery after scleral buckling, whereas Iwase et al 10 reported a decrease in the retinal blood flow in the optic nerve head using laser speckle flowgraphy for eyes with RRD, which successfully recovered after RRD repair with vitrectomy.…”