Corneal topographic changes after scleral buckling

PURPOSE. To evaluate corneal topographic changes and induced corneal astigmatism after scleral buckling (SB). METHODS. This interventional case series includes all patients who had undergone scleral buckling for rhegmatogenous retinal detachment (RRD) during a 1-year period. Patients we re divided into four groups according to type and extent of scleral buckling which depended on the discretion of a retina specialist. Videokeratography was performed for all patients preoperatively and repeated 1 and 3 months after SB. RESULTS. Thirty-nine eyes of 39 patients (29 male, 74.7%) with mean age of 50.35 +/- 20 years (range 13-80) were finally analyzed. There was no statistically significant difference among the groups in terms of preoperative corneal astigmatism, surface regularity index (SRI), surface asymmetry index (SAI), mean keratometry (mean K), and potential visual acuity (PVA). Overall, preoperative mean K was 43.97 +/- 1.78 D, which reached 44.2 +/- 2.02 D and 43.92 +/- 2.16 D 1 and 3 months after the operation. Mean preoperative SRI was 0.58 +/- 0.4, which incre a sed to 1.24 +/- 1.18 and 1.29 +/- 1.13 1 and 3 months after the operation respectively. Mean preoperative SAI was 0.39 +/- 0.21, which increased to 0.73 +/- 0.37 and 0.75 +/- 0.66 1 and 3 months after the procedure. Changes in SAI at 1 and 3 months following SB were significant (p values < 0.001); however, these postoperative values were not significantly different. Mean preoperative PVA was 0.07 +/- 0.75 logMAR (equivalent to 20/20) but decreased to 0.24 +/- 0.25 (equivalent to 20/30) and 0.27 +/- 0.29 (equivalent to 20/40) 1 and 3 months after SB, respectively. CONCLUSIONS. Significant changes in corneal topographic indices including increases in SRI and SAI and a concomitant decrease in PVA may occur after SB procedures. These induced changes must be considered and appropriately addressed postoperatively to provide the best possible corrected vision. (Eur J Ophthalmol 2006; 16: 536-41)