Extraocular Muscle Imbalance After Surgical Treatment for Retinal Detachment

Sewell, J. Jay; Knobloch, William H.; Eifrig, David E.

doi:10.1016/0002-9394(74)90096-8

Cited by 48 publications

(12 citation statements)

References 2 publications

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“…6,8,9 Regression analysis of our patients has not, however, shown an association between these variables and magnitude of strabismus.…”

Section: Discussioncontrasting

confidence: 73%

“…Most studies are retrospective and concerned with strabismus following scleral buckling (SB) repair of retinal detachments (RD). The reported incidence of post-operative diplopia varies between 3-14% in retrospective, and 73% in prospective studies, [1][2][3][4][5][6][7] being highest during the immediate post-operative period, and often transient when the vision is good. 3 The strabismus is reported greater with multiple VR procedures, encircling buckling elements rather than sectoral explants, and increasing number of muscles the explant is in direct contact with.…”

Section: Introductionmentioning

confidence: 99%

“…3 The strabismus is reported greater with multiple VR procedures, encircling buckling elements rather than sectoral explants, and increasing number of muscles the explant is in direct contact with. 2,[5][6][7][8] The strabismus has been attributed to several mechanisms including globe distortion, fibrotic adhesions, mass effect on muscle pulleys, the effects of local anaesthetic (LA), and sensory disturbance. Macula off RD and reduced postoperative visual acuity (VA) are associated with poorer outcomes for binocular vision.…”

Section: Introductionmentioning

confidence: 99%

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Strabismus following retinal detachment repair: a comparison between scleral buckling and vitrectomy procedures

Kasbekar

Wong

Young

et al. 2011

Eye

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Purpose We conducted a study to investigate: (1) deviations caused by retinal detachment (RD) repair; (2) correlation between visual acuity and the number of surgeries to deviation size; and (3) differences between deviations following scleral buckling (SB) and pars plana vitrectomy (PPV). Methods A retrospective analysis of patients with persistent binocular diplopia following RD repair. Magnitude of manifest deviation (|dev|) in the primary position (PP) and position of greatest deviation (maxDev) was calculated. LogMAR acuity and number of previous vitreoretinal procedures were correlated to |dev| in both PP and maxDev. Manifest |dev| were compared between SB and PPV groups. Results Twenty-five patients were identified. The median |dev| was 7 prism diopters (PD) in PP and 17 PD in maxDev. We found no association between number of surgeries or VA with |dev| in either the PP (r ¼ À0.18 and r ¼ 0.08) or maxDev (r ¼ À0.26 and r ¼ À0.05). Twelve patients underwent PPV: median |dev| in PP 6 PD and maxDev 9 PD. In the SB group: median |dev| in PP 8 PD and in maxDev 22 PD. |dev| in PP showed no significant differences between PPV and SB (U ¼ 63, P ¼ 0.41); however, |dev| in maxDev, showed that SB have significantly greater deviations (U ¼ 36.0, P ¼ 0.02). Conclusion We report the largest cohort of patients with symptomatic ocular motility defects following PPV. We show no association between VA or number of procedures to strabismus magnitude. Ocular deviations in maxDev are significantly greater after SB procedures.

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“…6,8,9 Regression analysis of our patients has not, however, shown an association between these variables and magnitude of strabismus.…”

Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Strabismus following retinal detachment repair: a comparison between scleral buckling and vitrectomy procedures

Kasbekar

Wong

Young

et al. 2011

Eye

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“…In the scleral buckling procedure, inadvertent complications may result, such as subretinal hemorrhage, extraocular muscle imbalance, and chorioretinal circulatory disturbances. Therefore, scleral buckling appears to have some limitations in achieving early functional recovery [25,27,33].…”

Section: Discussionmentioning

confidence: 98%

Conventional buckling surgery or primary vitrectomy with silicone oil tamponade in rhegmatogenous retinal detachment with multiple breaks

Afrashi

Erakgün

Akkin

et al. 2004

Graefe's Arch Clin Exp Ophthalmol

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“…Different explants and buckles used and different sur gical techniques have led to differing results. Sewell et al 15 in 1974 found that a significantly greater number of patients had muscle imbalance if a large volume of sili cone material was placed beneath one or more of the rec tus muscles. They considered a large explant to be a Mira 276, 277 or 279 circumferential explant or an 8 mm sponge.…”

Section: Discussionmentioning

confidence: 99%

Incidence of ocular motility problems following scleral buckling surgery

Spencer¹,

Newton²,

Vernon³

1993

Eye

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Nottingham SUMMARYThe incidence and severity of extraocular muscle imbal ance after conventional scleral buckling surgery was determined for 70 eyes of 68 patients with primary rheg matogenous retinal detachment. Fifty-eight eyes had cir cumferential 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).Scleral buckling operations are known to cause post operative strabismus in some patients. Previous studies l -18 have quoted an incidence ranging from 3% to 57% of cases. Many authors have been unable to demonstrate a relationship to the type or position of the explant. One prospective study 19 demonstrates a higher incidence of muscle imbalance on detailed examination. Many of these studies include surgical techniques no longer in common use. This study evaluates the incidence and severity of extraocular muscle imbalance after retinal detachment surgery for primary rhegmatogenous detachment over a 2-year period. PATIENTS AND METHODSOne hundred and thirteen patients were identified from theatre records who had had primary rhegmatogenous ret inal detachment surgery between 1 January 1990 and 31 December 1991. Of these, 5 patients had moved away from the area, 18 had been secondary referrals from out side the catchment area, 3 further patients had died and 2 Eye (1993) 7, 751-756 had developed new ophthalmic problems which could affect ocular motility (namely dysthyroid eye disease and herpes zoster ophthalmicus). Two patients were untrace able on computer records. Of 83 remaining patients. invited to attend for full ocular motility examination 72 accepted. One was excluded from the study because of sympathetic ophthalmitis, and 3 more were excluded for incomplete data as the hospital records could not be found. The results from 68 patients (i.e. 82% of those invited) are therefore presented.From the patients' records the following data was col lected: (1) age, (2) sex, (3) previous history of strabismus, (4) history of previous ocular surgery, (5) best corrected visual acuity of affected eye and of the fellow eye as recorded, (6) whether the macula was detached, (7) ten otomy of any muscle at surgery, (8) location of the explant, (9) whether the explant was radial or circumferential, (10) size of explant, (11) whether diplopia had been a post operative complaint and whether any treatment had been required.The post-operative assessment was performed at least 7 months after surgery. Details of the ret...

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Extraocular Muscle Imbalance After Surgical Treatment for Retinal Detachment

Cited by 48 publications

References 2 publications

Strabismus following retinal detachment repair: a comparison between scleral buckling and vitrectomy procedures

Strabismus following retinal detachment repair: a comparison between scleral buckling and vitrectomy procedures

Conventional buckling surgery or primary vitrectomy with silicone oil tamponade in rhegmatogenous retinal detachment with multiple breaks

Incidence of ocular motility problems following scleral buckling surgery

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