A comparative study of strabismus surgery with retained or removed scleral explant after retinal detachment surgery

Abstract

Purpose To compare, in a larger study population, the outcomes of strabismus surgery in patients who either had the scleral explant (EX) retained or removed after surgery for retinal detachment. Methods A comparative retrospective study includes data from 2 centres. Surgical outcome, motor success, sensory success, the number of secondary operations for strabismus and complications were compared between the two groups. Motor success was defined as horizontal deviation of ≤6 prism diopters (PD) and vertical deviation of ≤6PD. Sensory success was defined as no diplopia without use of prism. Results Forty‐seven patients were included in the study; 70% had retained the EX and 74% had vertical strabismus. Horizontally, the final alignment was equal between the 2 groups, 4 PD vs.5 PD in the EX removed group. The patients with retained EX were referred with a significant lower mean vertical deviation and had a significant lower post‐operative mean vertical deviation of 2 PD vs. 3 PD in the EX‐removed group. The rates of motor success (76% vs. 71%) and sensory success (79% vs. 93%) did not differ significantly between the EX‐retained and EX‐removed groups. No patients underwent more than 2 operations. Two complications occurred in the EX‐retained group: a subconjunctival cyst and an exposed EX. In the EX‐removed group, 2 patients with retinal re‐detachment were found in the follow‐up period. Conclusion Good surgical outcomes including high motor and sensory success were obtained regardless of the presence of the EX. Retinal re‐detachment was observed in two patients with previously removed EX.