Vitrectomy for Macular Traction Caused by Incomplete Vitreous Separation

• Pars plana vitrectomy was performed in 16 eyes to release vitreomacular traction. All patients had a symptomatic preoperative decrease in visual acuity, most often to 20/200. Partial detachment of the posterior vitreous surface was associated with vitreoretinal attachment remaining in the area of the macula and sometimes to the optic nerve head. The posterior vitreous traction on the macula was released by tangential traction on the posterior vitreous surface, causing it to separate from the retina. The postoperative vision was the same or improved in each case. No operative complications occurred, but progressive nuclear sclerosis developed postoperatively in five of the 15 phakic eyes

Extraocular Muscle Imbalance after Scleral Buckling Surgery

Pneumatic retinopexy is advocated to treat some retinal detachment cases, in part to avoid the complication of induced strabismus sometimes associated with scleral buckling procedures (SBPs). Prospective evaluation of postoperative muscle imbalance was performed in 76 eyes of 69 patients undergoing SBP. Measureable limitation of ductions occurred in 40 (73%) of the 55 eyes for which a full set of duction measurements could be obtained. Among 53 patients without previous retinal surgery in either eye, postoperative deviations were associated with encircling scleral buckles (P = 0.00003), but not with radial scleral buckles (P = 0.6). Significant strabismus occurred in 12 patients (23%), and three required surgery or prism therapy. Candidates for pneumatic retinopexy can usually be treated by a radial scleral buckling procedure, and therefore the risk of postoperative strabismus is low if this technique is selected

Refractive Changes After Scleral Buckling Surgery

• Pneumatic retinopexy is increasingly recommended to treat some patients with retinal detachment to avoid the complication of induced refractive changes sometimes associated with scleral buckling procedures. Prospective evaluation of refractive changes after scleral buckling procedures was performed in 75 eyes of 69 patients. Encircling scleral buckles caused an average increased axial length of 0.99 mm and average induced myopia of 2.75 diopters. Induced astigmatism was likely to occur in patients undergoing scleral buckling surgery, but it was not related to whether a radial element was used