Background/Aim: Spectral domain optical coherence tomography (SD-OCT) is very
useful for accurate examination of macular microstructure. The aim of this
study was to evaluate macular morphologic changes after successful retinal
detachment (RD) surgery by scleral buckling using SD-OCT and assess their
impact on vision repair. Methods: SD-OCT examination was performed 1, 6 and
12 months in 27 eyes following scleral buckling (SB) surgery with successful
anatomical repair of rhegmatogenous retinal detachment (RRD) which also
affected the macular region. The examination was performed in a 6mm diameter
central macular region and included measurements of the central foveal
thickness (CFT), average overall retinal thickness and thickness of the
outer and inner retinal layers separately. The numerical values of operated
eyes were compared with those of the fellow (control) eyes. The condition of
the outer limiting membrane (ELM) and inner segment/outer segment of the
photoreceptors (IS/OS) was also examined. Results: The mean total and outer
retinal thickness (TRT and ORT) in the reattached regions in the operated
eyes were significantly thinner than the corresponding regions of the fellow
(control) eye, and throughout the follow-up period the difference was
statistically significant. There was a statistically significant difference
in TRT (after 1 month p=0.021, after 6 months p=0.026, after 12 months
p=0.027) and ORT (after 1 month p=0.018, after 6 months p=0.019, after 12
months p=0.021) between the eyes with a longer pre-operative duration of
macular detachment of 2 weeks and eyes with shorter detachment period.
Disruptions of the photoreceptors IS/OS and ELM on OCT examination after one
month were observed in 37.04% eyes, after 6 months in 29.6% eyes, and at the
end of the follow-up period in 14.8% eyes. A statistically significant
difference was found in the frequency of disruptions of the IS/OS and ELM
depending on the preoperative duration of RD (p= 0.007). Conclusion: Overall
decrease in the mean retinal thickness after successful anatomical repair of
RD is result of decreases in the thicknesses of outer retinal layers. The
alterations of the external limiting membrane and inner and outer
photoreceptors segments observed on the early SD-OCT scans are mostly
associated with limited visual recovery. The prolonged macular detachment
leads to damage to the neurosensory tissue of the retina and especially the
photoreceptors, which may explain the limited visual recovery after
successful scleral buckling RD repair.
Forced Duction Test: Is It Necessary after the Scleral Buckling Procedure?
