Scleral ectasia in rhegmatogenous retinal detachment

Objective: To determine the relation between retinal tears and scleral ectasia. Design: Prospective study. Setting: University-based referral practice in Montreal. Patients: Fifty-seven consecutive patients with primary rhegmatogenous retinal detachments undergoing scleral buckling surgery. Patients with a history of trauma or previous cryotherapy, laser treatment or other vitreoretinal procedures were excluded. Fifteen patients with diabetes mellitus undergoing primary vitrectomy and prophylactic scleral buckling for nonclearing vitreous hemorrhage constituted the control group. Outcome measures: Presence of scleral ectasia, visual acuity, refractive error. Results: Thirty-one of the study patients were phakic and 26 were aphakic or pseudophakic. Fifteen (48.4%) of the phakic patients were found to have scleral ectasia, compared with six (23.1%) of the aphakic/pseudophakic patients and two (13.3%) of the control patients (p < 0.05, chi(2) test). The most frequent location of ectasia was the superotemporal quadrant. Retinal tears occurred in the same quadrant as scleral ectasia in 12 (80.0%) of the phakic patients. Conclusions: Scleral ectasia may be causally related to rhegmatogenous retinal detachment in certain cases.