Posters

Corneal astigmatism induced by scleral buckling surgery

Poster Details

First Author: N.Lachkham MOROCCO

Co Author(s): C. Filali   M. Firdaoussi   A. Bennis   F. Chraibi   M. Abdellaoui   I. Benatiya Andaloussi     

Abstract Details

Purpose:

Scleral buckling is an essential time in conventional retinal detachment surgery. It enables to re-establish retinal contact and to counterbalance vitreal tractions. However, it causes corneal shape changes which lead to postoperative astigmatism. Therefore, surgeons become interested in the refractive alterations induced to improve the quality of postoperative visual function.  This study was designed to evaluate the induced corneal astigmatism after scleral buckling surgery for retinal detachment using corneal topography examination.

Setting:

It is a short-term prospective study which took place at the ophthalmology department of Hassan II university hospital, Sidi Mohamed Ben Abdellah univerity of Fez - Morocco, from November 2018 to August 2019.

Methods:

The study included 32 eyes of 32 patients with the diagnosis of rhegmatogenous retinal detachment. Scleral buckling surgery was performed on all patients. The corneal topography of each patient was measured before surgery and at 1 week, 1 month and 3 months after surgery using Pentacam®HR Scheimpflug camera system. We analyzed changes in corneal astigmatism and corneal axis meridians using the main page of Pentacam and the four main refractive maps. The data was saved on Microsoft Excel® and analyzed by SPSS® software 20 version.

Results:

The mean age of the patients was 45 years and 78% were women. Total corneal astigmatism before surgery was found to be mean 1,86D. It reached its highest level in the first postoperative week (mean: 2,82D). The difference was statistically significant. The amount of corneal astigmatism decreased gradually and was a mean of 2,5D by the first postoperative month (p=0,010) and 2,15D at 3months (p=0,004). These differences were also statistically significant. Another significant difference was noted. It concerns the Steeper corneal meridian’s modification. It rotated by 58,2° at one week, 47,2° at one month and 45,4° at three months.

Conclusions:

Scleral buckling surgery induced a significant postoperative corneal astigmatism. Although a statistically significant irregular astigmatism was a portion of this postoperative corneal astigmatism in our study, it was not considered to be too great to disturb visual performance. All these changes began to reserve by the first month after surgery. We conclude that, as one of the most common surgical procedure used in retinal detachment surgery, scleral buckling may cause transient changes in corneal shape and ocular refractive status postoperatively and these changes can be easily detected by using Pentacam Topograph.

Financial Disclosure:

None