Higher Order Aberrations following Scleral Buckling Surgery in Patients with Rhegmatogenous Retinal Detachment

We aim to evaluate magnitudes of higher order aberrations (HOAs) from 3rd-6th order after scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). A retrospective cross-sectional study of 19 patients with RRD who received SB (six receiving encircling SB, thirteen receiving segmental SB) was conducted. A wavefront analysis for surveying HOAs and other ophthalmic parameters were collected. Data between operated and fellow eyes, and a subgroup analysis of operated eyes, were analyzed by the Mann-Whitney U test, while a generalized linear model was applied to evaluate the correlation of HOAs to best-corrected visual acuity (BCVA) and optical symptoms. BCVA in the operated eyes was significantly worse (LogMAR: 0.18 +/- 0.23 versus 0.05 +/- 0.07, p = 0.001). Tilt (0.32 +/- 0.14 versus 0.13 +/- 0.08, p = 0.004), defocus (1.78 +/- 0.47 versus 1.05 +/- 0.17, p = 0.019) and coma (0.43 +/- 0.11 versus 0.27 +/- 0.09, p = 0.016) were significantly increased after SB. All root mean square (RMS), including RMS-3, RMS-4 and total RMS, were higher in operated eyes (all p < 0.05). Regarding Zernike terms, a significant elevation of vertical coma in the operated eyes was found (p = 0.038). In addition, tilt (0.41 +/- 0.10 versus 0.17 +/- 0.12, p = 0.007), defocus (2.27 +/- 0.58 versus 0.82 +/- 0.39, p = 0.001) and coma (0.59 +/- 0.17 versus 0.11 +/- 0.10, p = 0.015) were higher in the segmental subgroup, whereas spherical aberration (SA) was higher in the encircling subgroup (0.22 +/- 0.04 versus 0.40 +/- 0.15, p = 0.024) and RMS-4 and total RMS were increased in the segmental subgroup (both p < 0.05). Besides, tilt was correlated to worse BCVA (p = 0.036), whereas all four HOAs were correlated to the presence of optical symptoms (all p < 0.05). In conclusion, SB may increase HOAs, which could be associated with unfavorable postoperative visual outcomes and subject symptoms.