Corneal shape changes after scleral buckling surgery

Purpose: A prospective study was conducted to investigate the corneal shape changes due to scleral buckling surgery. These changes were analyzed based on the type of buckling procedures performed. Methods: A total of 89 eyes from 88 patients were stratified into four groups based on the type of buckling procedures used, including: group A, local buckling, group B, encircling; group C, encircling with vitrectomy; and group D, encircling with additional segmental buckling. These eyes underwent keratometry and videokeratography examinations before surgery as well as at 1, 3, and 6 months after surgery. Results: No statistical significance was observed in the amounts of the induced corneal astigmatism and the refractive cylinder among the four groups. After local or segmental buckling (groups A and D), corneal steepening, which corresponded to the buckle, occurred at a high incidence. After encircling (groups B and C), either peripheral corneal flattening with focal central steepening or flattening on one side with coupled steepening on the opposite side was observed. Such corneal changes persisted for up to 6 months in an irregular and asymmetric configuration. Conclusions: All four types of circumferential scleral buckling surgery were found to produce prolonged irregular and asymmetric corneal shape changes, whereas the patterns of the changes differed depending on the buckling procedures used.