Central corneal topographic changes after retinal detachment surgery

Alterações topográficas da área central da córnea após cirurgia de descolamento de retina

SUMMARY

Purpose:

To analyze early central corneal topographic changes induced by encircling band procedure to better understand its influence on corneal curvature and visual rehabilitation.

Methods:

Twelve patients with regmatogenic peripheral retinal detachment, without macular involvement, were evaluated regarding best corrected visual acuity, biomicroscopy, tonometry, fundoscopy, axial length ultrasonography and corneal topography, both preoperatively and 4 weeks postoperatively. Paired t tests were used to compare pre and postop-surgical values.

Results:

We found statistical significant central flattening in 11 out of 12 cases with mean flattening of 1.22 diopters ±1.73 (p < 0.05). There was a minimal change in the axial length with no statistical significance.

Conclusion:

Refractive changes after encircling procedure are frequent and play an important role in the final visual acuity, especially in patients with healthy or nonaffected macula. The nature of these changes apparently depends upon the type of procedure used.

Keywords:
Retinal detachment surgery; Corneal topography; Cornea curvature; Astigmatism; Computerized videokeratography

RESUMO

Objetivo:

Analisar alterações corneais precoces induzidas por cirurgia de cerclagem, para melhor entender sua influência sobre a curvatura corneal e a reabilitação visual.

Método:

Doze pacientes com descolamento de retina regmatogênico periférico sem envolvimento macular foram avaliados quanto à acuidade visual melhor corrigida, biomicroscopia, tonometria, fundoscopia, comprimento axial por ultrassonografia e topografia de córnea, tanto no período pré-operatório quanto 4 semanas no período pós-operatório. Testes t pareados foram usados para comparar valores pré e pós-operatórios.

Resultado:

Encontramos aplanamento central significante estatisticamente em 11 dos 12 pacientes com média de 1,22 Dioptrias ±1,73 (p < 0,05). Houve mínima alteração no comprimento axial, sem significância estatística.

Conclusão:

Alterações refrativas após procedimento de cerclagem são freqüentes e desempenham importante papel na acuidade visual final, especialmente em pacientes que não apresentam comprometimento macular. A natureza destas alterações dependem aparentemente do tipo de procedimento feito.

Palavras-chave:
Descolamento de retina; Topografia de córnea; Curvatura corneal; Astigmatismo; Vídeoceratografia computadorizada

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• Department of Ophthalmology/Santa Casa de São Paulo - SCSP, Brazil.
• Department of Ophthalmology, University of São Paulo (USP), Brazil.
• Department of Ophthalmology/ California Pacific Medical Center - CPMC (San Francisco, CA), USA.
• Department of Ophthalmology/ University of California, San Francisco - UCSF, USA.
• Presented as a poster at the ARVO Meeting 1997, Sarasota, Fl, USA.
• The authors have no financial interest in any product or equipment cited in this paper.

REFERENCES

• ¹
  Burton TC, Lambert RW Jr. A predictive model for visual recovery following retinal detachment surgery. Ophthalmology 1978;85:619-25.
• ²
  Tani P, Robertson DM, Langworthy A. Prognosis for central vision and anatomic reatachment in rhegmatogenous retinal detachment with macula attached. Am J Ophthalmol 1981;92:611-20.
• ³
  Fiore IV, Newton JC. Anterior segmental changes following the scleral buckling procedure. Arch Ophthalmol 1984;84:284-7.
• ⁴
  Burton TC. Irregular astigmatism following episcleral buckling procedure. Arch Ophthalmol 1973;90:447-8.
• ⁵
  Burton TC, Herron BE, Ossoinig KC. Axial length changes after retinal detachment surgery. Am J Ophthalmol 1977;83(1):59-62.
• ⁶
  Goel R, Crewdson L, Chignell AH. Astigmatism following retinal detachment surgery. Br J Ophthalmol 1983;67:327-9.
• ⁷
  Harris JM, Blumenkranz MS et al. Geometric alterations produced by encircling scleral buckles. Biometric and clinical considerations. Retina 1987;7(1):14-9.
• ⁸
  Smiddy WE, Loupe DM et al. Refractive changes after retina! detachment surgery corrected by extended wear contact lenses early visual rehabilitation. Retina 1993;13(2):120-4.
• ⁹
  Tomambe PE. Consider prior RK in planning retinal reattachment surgery. Ophthalmology News March 1, 1994, page 9.
• ¹⁰
  Shapland CD. Changes in refraction of the eye following the operation of lamellar scleral resection. Eye 1953;73:205-9.
• ¹¹
  Bivner I. Alterations in refraction and their clinical significance. Ear Nose Throat J 1958;37:676-8.
• ¹²
  Rosenthal ML. Discussion in Vitreous Body in Retinal Surgery, CV Mosby, St. Louis 1960; p.165-7.
• ¹³
  Rubin ML. The induction of refractive error by retinal detachment surgery. Trans Am Ophthalmol Soc 1975;73:452-90.
• ¹⁴
  Larsen JS, Syrdalen P. Ultrassonographic study on changes in axial eye dimensions after encircling procedure in retinal detachment surgery. Acta Ophthalmol 1979;57:337-43.
• ¹⁵
  Muller-Albach KA, Dick B, Pavlovic S Changes in bulbus geometry after conventional detachment surgery. Study using videokeratoscopy. Ophthalmologe 1995;92(5):677-80.
• ¹⁶
  Hayashi H, Hayashi K, Nakao F, Hayashi F. Corneal shape changes after scleral buckling surgery. Ophthalmology 1997;104:831-7.

Publication Dates

• Publication in this collection
  Apr 1999