Mohammadkhani Mahdi, Ahoor Mohammadhosein, Niyousha Mohamadreza, Vahedi Hadi, Khavandi Siamak, Bagheri Masood, Daneshyar Chiman, Jafarizadeh Ali
Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Ophthalmology, Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Int Ophthalmol. 2025 Jun 20;45(1):247. doi: 10.1007/s10792-025-03606-2.
Encircling scleral buckling is a surgical intervention employed for the purpose of visual restoration in individuals diagnosed with rhegmatogenous retinal detachment (RRD). While this particular approach is not commonly used for the purpose of enhancing accommodation, it has garnered attention in various studies. This research aimed to objectively measure accommodation changes using the iTrace device in patients with RRD who have undergone encircling scleral buckling surgery.
This pilot prospective cohort study included 40 eyes from 20 patients with RRD who underwent encircling scleral buckling surgery in one eye. The surgical group included 20 RRD eyes and the non-exposure group included 20 healthy eyes. The objective aberrometry was performed by directing a light beam at a 6-m and 20-cm distant using the iTrace. We assessed post-surgical accommodation changes within two groups using the Wilcoxon signed-rank test, quantified clinically relevant changes with the mean difference (MD), and evaluated change magnitude with the standardized mean difference (Hedges' g).
The average age of the patients was 33.9 ± 8 years, with 12 males and 8 females. Baseline accommodation for the non-operated eye measured 2.76 diopters at 20 cm and 1.37 diopters at 50 cm. At 20 cm, the non-operated and operated eyes showed mean accommodation changes of 0.2 diopters (p = 0.123) and 0.01 diopters (p = 0.949), respectively. At 50 cm, the non-operated eye changed by 0.12 diopters (p = 0.292) while the operated eye decreased by - 0.01 diopters (p = 0.930). Overall, minor postoperative accommodation changes were observed, with no significant differences detected.
Encircling scleral buckling in RRD patients shows no significant changes observed postoperatively in either operated or non-operated eyes and the 98.75% CI suggests any potential benefit is likely too small to be clinically meaningful.
环扎巩膜扣带术是一种用于诊断为孔源性视网膜脱离（RRD）患者视力恢复的手术干预措施。虽然这种特定方法通常不用于增强调节功能，但在各种研究中已受到关注。本研究旨在使用iTrace设备客观测量接受环扎巩膜扣带术的RRD患者的调节变化。
这项前瞻性队列研究纳入了20例RRD患者的40只眼，其中一只眼接受了环扎巩膜扣带术。手术组包括20只RRD眼，非暴露组包括20只健康眼。使用iTrace在6米和20厘米远处投射光束进行客观像差测量。我们使用Wilcoxon符号秩检验评估两组术后的调节变化，用平均差（MD）量化临床相关变化，并用标准化平均差（Hedges' g）评估变化幅度。
患者的平均年龄为33.9±8岁，男性12例，女性8例。未手术眼在20厘米处的基线调节力为2.76屈光度，在50厘米处为1.37屈光度。在20厘米处，未手术眼和手术眼的平均调节变化分别为0.2屈光度（p = 0.123）和0.01屈光度（p = 0.949）。在50厘米处，未手术眼变化了0.12屈光度（p = 0.292），而手术眼下降了-0.01屈光度（p = 0.930）。总体而言，术后调节变化较小，未发现显著差异。
RRD患者的环扎巩膜扣带术在手术眼和未手术眼中术后均未观察到显著变化，98.75%的置信区间表明任何潜在益处可能太小，无临床意义。
