Clinical Observation Of Refractive Parameters Of Scleral Buckling Surgery For Rhegmatogenous Retinal Detachment

Objective:To observe the changes and influencing factors of refractive parameters in patients with rhegmatogenous retinal detachment after scleral buckling alone and scleral buckling combined with cerclage respectively,and to further analyze the possible causes and mechanism of these changes.Methods: A total of 40 eyes of 40 patients with rhegmatogenous retinal detachment in our hospital from October 2017 to February 2019 and successfully performed scleral buckling operation were selected.15 eyes underwent scleral buckling(SB group)and25 eyes underwent scleral buckling combined with cerclage(combined group).The best corrected visual acuity,corneal curvature,axial length,anterior chamber depth were measured 1-2 days before operation,1 week after operation and 1 month after operation and we comparedthe changes of these data before and after operation and between the two groups.The changes of the best corrected visual acuity,corneal curvature,axial length,anterior chamber depth before operation and 1 week after operation and 1 month after operation in the same group were compared by and the changes of the best corrected visual acuity,corneal curvature,axial length and anterior chamber depth at the same time between the two groups were compared.We analyzed the factors that may affect the recovery of best corrected visual acuity,such as age,sex and myopia degree.Results:There were no significant differences in age,sex,myopia degree,axial length,corneal curvature,anterior chamber depth and best corrected visual acuity before operation between the two groups(P>0.05).Compared with one week after scleral buckling surgery and before,the differences in axial length,anterior chamber depth,corneal vertical curvature and best corrected visual acuity were statistically significant(P<0.05),but there was no significant difference in corneal horizontal curvature(P>0.05).Compared with one month after scleral buckling surgery and one week after,the differences in anterior chamber depth,corneal vertical curvature and best corrected visual acuity were statistically significant(P<0.05),but there were no significant differences in axial length and corneal horizontal curvature(P>0.05).Compared with one week after scleral buckling combined with cerclage and before,the differences in axial length,anterior chamber depth,corneal horizontal curvature,corneal vertical curvature and best corrected visual acuity were statistically significant(P<0.05).Compared with one month after scleral buckling combined with cerclage and one week after,the differences in axial length,anterior chamber depth,corneal horizontal curvature,corneal vertical curvature and best corrected visual acuity were statistically significant(P<0.05).There were significant differences in axial length and anterior chamber depth between SB group and combined group after operation.The best corrected visual acuity before operation affects the recovery of visual acuity after operation(P<0.05),and there was no significant correlation between the patients' sex,age,eye axis length and the recovery of visual acuity after operation(P>0.05).Conclusion:1.After scleral buckling surgery for the patients with rhegmatogenous retinal detachment,the best corrected visual acuity improved,the depth of anterior chamber shallower,the axis length increased,the corneal vertical curvature enlarged.For some time after operation,the best corrected visual acuity,anterior chamber depth and corneal vertical curvature remained their trends but axis length and corneal horizontal curvature tended to be stable;2.After scleral bucklingcombined with cerclagefor the patients with rhegmatogenous retinal detachment,the best correctedvisual acuity improved,the depth of anterior chamber shallower,the axis length increased,the corneal horizontal curvature reduced and the corneal vertical curvature enlarged.For some time after operation,the best corrected visual acuity,anterior chamber depth,the axis length,and corneal vertical curvature remained their trends but the corneal horizontal curvatureenlarged;3.Compared with SB group and combined group,the changes of axial length and anterior chamber depth were more obvious in combined group;4.For non-complex rhegmatogenous retinal detachment,simple scleral buckling should be performed as far as possible;5.The best corrected visual acuity before operation is afactor affecting visual acuity recovery after operation.