Karimian F, Moradian S, Yazdani S, Mashayekhy A, Anisian A, Kouhestani N
Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center (LMC), Shaheed Beheshti University of Medical Sciences, Boostan 9th Street, Pasdaran Avenue, Tehran, Iran 16666.
Eur J Ophthalmol. 2006 Jul-Aug;16(4):536-41. doi: 10.1177/112067210601600406.
To evaluate corneal topographic changes and induced corneal astigmatism after scleral buckling (SB).
This interventional case series includes all patients who had undergone scleral buckling for rhegmatogenous retinal detachment (RRD) during a 1-year period. Patients were 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.
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 increased 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.
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.
评估巩膜扣带术（SB）后角膜地形图变化及诱导性角膜散光。
本干预性病例系列纳入了在1年期间因孔源性视网膜脱离（RRD）接受巩膜扣带术的所有患者。根据巩膜扣带的类型和范围将患者分为四组，这取决于视网膜专科医生的判断。对所有患者在术前进行了角膜地形图检查，并在巩膜扣带术后1个月和3个月重复检查。
最终分析了39例患者的39只眼（男性29例，占74.7%），平均年龄为50.35±20岁（范围13 - 80岁）。各组之间在术前角膜散光、表面规则性指数（SRI）、表面不对称指数（SAI）、平均角膜曲率（平均K）和潜在视力（PVA）方面无统计学显著差异。总体而言，术前平均K为43.97±1.78 D，术后1个月和3个月分别达到44.2±2.02 D和43.92±2.16 D。术前平均SRI为0.58±0.4，术后1个月和3个月分别增至1.24±1.18和1.29±1.13。术前平均SAI为0.39±0.21，术后1个月和3个月分别增至0.73±0.37和0.75±0.66。巩膜扣带术后1个月和3个月时SAI的变化具有显著性（p值<0.001）；然而，这些术后值之间无显著差异。术前平均PVA为0.07±0.75 logMAR（相当于20/20），但在巩膜扣带术后1个月和3个月分别降至0.24±0.25（相当于20/30）和0.27±0.29（相当于20/40）。
巩膜扣带术后可能会出现角膜地形图指标的显著变化，包括SRI和SAI增加以及PVA随之降低。术后必须考虑并适当处理这些诱导性变化，以提供最佳的矫正视力。
