Refractive State Changes Of Scleral Buckling Surgery For Rhegmatogenous Retinal Detachment

Objective To observe the change of the best corrected visual acuity(BCVA),corneal curvature,anterior chamber depth,lens thickness and eye axial and the factors influencing the refractive changes for rhegmatogenous retinal detachment(RRD)after scleral buckling surgery.Methods We were used to clinical retrospective study about 30 patients with 30 eyes RRD for scleral buckling surgery treatment,including 20/30 eyes by scleral padding,10/30 eyes by scleral encircling.We were followingthem once a month after operation to measureof the patient’s best corrected visual acuity(BCVA),corneal curvature,anterior chamber depth,lens thickness and eye axial.The best corrected visual acuity(BCVA),corneal curvature,anterior chamber depth,lens thickness and axial length were compared by ANOVA at different time points before and after operation.Then the independent sample t test was used,and if there was time difference at each time point,the LSD-t test of pairwise comparison was used,correlation test of the correlation between anterior chamber depth,lens thickness,corneal curvature,axial length and the correlation of the equivalent sphere lens measured at different time pointsand the difference was statistically significant(P < 0.05).Results 30 eyes were followed up for 6 to 12 months,there was no significant difference in the visual acuity between the scleral padding group and the scleral encircling group(F=0.054,P > 0.05).The visual acuity of two groups of scleral buckling was higher than that before operation,and the difference was statistically significant(P < 0.05).The difference between the scleral padding group and the scleral encirclinggroup in eye axis was statistically significant(F=6.710,P < 0.05).Scleral buckling in two groups after operation compared with the preoperative axial growth,the difference was statistically significant(P <0.05),eye axial did not increase significantly in the scleral padding surgery compared with the preoperative,the difference was not statistically significant(P > 0.05),the sclera encircling surgery compared with the preoperative,the eye axial growth than before.The difference was statistically significant(P < 0.05).There was significant difference between the scleral padding group and the scleral encirclinggroup in vertical curvature of cornea(F=3.234,P < 0.05).The vertical curvature of cornea was increased in two groups after scleral buckling,and the difference was statistically significant(P < 0.05).There was nosignificant difference between the scleral padding group and the scleral encirclinggroupin the horizontal curvature of cornea(F=1.837,P>0.05).The horizontal corneal curvature was increased in scleral buckling surgery compared with the preoperative,the difference was statistically significant(P < 0.05),in which the curvature horizontal corneal in the scleral padding after operation showed no obvious changes,the difference was not statistically significant(P > 0.05),the curvature horizontal corneal in the scleral encircling after operation was no obvious change before operation,there was no statistically significant difference(P>0.05).There was significant difference in the anterior chamber depth between the scleral padding group and the scleral encirclinggroup(F=1.344,P > 0.05).The anterior chamber depth of two groups of scleral buckling was higher than that before operation,and the difference was statistically significant(P < 0.05).There was significant difference in the thiess of the lens between the scleral padding group and the scleral encircling group(F=1.567,P > 0.05).The thiess of the lens of two groups of scleral buckling was higher than that before operation,and the difference was statistically significant(P < 0.05).The equivalent spherical mirror was more greaten,BCVA more improved,vertical corneal curvature bigger,shallow anterior chamber and lens thickening after scleral buckling surgery,but there was no significant alteration of the level corneal curvature.The changes of the eye axis were obvious after the scleral encircling,and the corneal curvature was significantly changed after the scleral padding.The changes of the scleral encircling were obvious to the scleral padding.During the follow-up found no systemic adverse reactions and eye complications.Conclusions After scleral buckling surgery for rhegmatogenous retinal detachment,the visual acuity was improved,anterior chamber shallower,lens thickened,corneal vertical curvature enlarged,and the axis of eye lengthened or not obvious.The diopter negative increase for rhegmatogenous retinal detachment after scleral buckling surgery,eye axis changes obviously after thescleral encircling,corneal curvature changes obviously after thescleral padding,but anterior chamber depth and the lens thickness changes are also involved.