Forced Duction Test: Is It Necessary after the Scleral Buckling Procedure?

A 14-year-old boy who had ocular motility disorder which started 2 weeks following retinal surgery (scleral buckling) secondary to rhegmatogenous retinal detachment, was referred to the strabismus clinic. He had significant ocular movement limitations in adduction and elevation under general anesthesia. The forced duction test (FDT) was positive in both adduction and elevation. After buckle removal, FDT was negative. The eye was orthotropic without ocular movement limitation at final follow-up. In conclusion, FDT at the end of the scleral buckling procedure needs to be performed. It may prevent restrictive strabismus after scleral buckling surgery.

Applying Sutureless Encircling Number 41 Band and Transscleral Chandelier-Assisted Laser Retinopexy for Scleral Buckling Procedure

Purpose. To assess the outcome of sutureless encirlcing number 41 band and transscleral laser retinopexy in uncomplicated rhegmatogenous retinal detachment (RRD), using a wide-angle viewing system (WAVS) and chandelier endoillumination.Methods. Prospective intervention study included 30 eyes of 30 patients presenting with RRD of recent onset indicated for SB. All cases were treated by sutureless encircling number 41 band and transscleral laser retinopexy. Visualization was provided by the Resight WAVS and a single 27-gauge chandelier endoillumination. Anatomical and visual outcomes were evaluated.Results. The mean age of our group was 49.8 ± 12.3 years, and the mean duration of RD was 7 (0–50) days. Twenty-four eyes (80.0%) were phakic while the remaining 6 eyes (20%) were either pseudophakic or aphakic. The primary retinal reattachment rate was 83.3% (25 out of 30 eyes). LogMAR visual acuity improved from 1.3 (0.30–2.0) preoperatively to 1.0 (0.40–1.60) at first month (p=0.002) and to 0.70 (0.20–1.92) at third month (p<0.001).Conclusion. Sutureless encircling number 41 band with chandelier-assisted transscleral laser retinopexy is a safe and effective technique for managing uncomplicated RRD. It provides a high primary success rate while eliminating the complications of cryotherapy, sutures, and broad buckles.

MODIFIED SCLERAL BUCKLING WITH A NON-CONTACT WIDE ANGLE VIEWING SYSTEM AND A 25G CHANDELIER ENDOILLUMINTOR

Purpose:To evaluate the outcome of scleral buckling surgery using a wide angle non-contact viewing system and chandelier endoillumination for per-operative fundus visualization in patients with non-complex rhegmatogenous retinal detachments.Materials and Methods:This was a prospective, interventional study carried out at the Department of Ophthalmology, Mayo Hospital Lahore over a period of six months. Non-probability convenience sampling technique was employed. Fifteen eyes of fifteen pati-ents underwent modified scleral buckling procedure for rhegmatogenous retinal detachment using a 25G Awh Chandelier (inserted into the sclera through the pars plana) and wide angle viewing system to view the fundus intraoperatively instead of the conventional Indirect Ophthalmoscope.Results:The mean age of the patients in this study group was 41.9 12.4 years. Out of fifteen patients, 13 had flat retinas postoperatively. Two patients had to undergo pars plana vitrectomy with silicone oil tamponade due to development of retinal detachment secon-dary to PVR.Conclusion:Modified scleral buckling with the con-current use of a chandelier light and wide angle viewing system provides an easier and more convenient means of visualizing the fundus under panoramic viewing conditions intraoperatively.Key Words:Wide angle viewing system. Retinal detachment. Scleral buckling. Endoillumination.

A Case of Extrusion of a Solid Silicone Tire Migrating through the Superior Rectus Muscle withAeromonas hydrophilaInfection following a Scleral Buckling Procedure

To our knowledge, there are no reports ofAeromonas hydrophilainfection after a scleral buckling procedure. Also, migration of a silicone explant element through the rectus muscles is extremely rare. Herein, we describe a case experiencing extrusion of a solid silicone tire migrating through the superior rectus muscle withAeromonas hydrophilainfection following a scleral buckling procedure. A 42-year-old man was referred to our hospital complaining of ocular pain and purulent discharge in his left eye which has persisted for several months. He had a history of bilateral rhegmatogenous retinal detachment which had been treated with scleral buckling. The left eye showed extrusion of the solid silicone buckle which had migrated through the superior rectus muscle and an infection in the upper quadrant of the sclera. The buckle was removed, and the patient was treated with antibiotics. After the removal of the buckle, the symptoms showed rapid amelioration and there was no recurrence of retinal detachment.Aeromonas hydrophilawas isolated from the discharge and the removed explant. He used well water in daily life. In this case, theAeromonas hydrophilainfection of the extruded buckle might have originated from contaminated well water.