[Diplopia complicating scleral buckling surgery for retinal detachment]

Abstract

Introduction: Diplopia is a well-known complication of scleral buckling for retinal detachment. It is generally caused by ocular motility disturbances.

Subjects and methods: We conducted a retrospective study on patients operated on for retinal detachment between 1998 and 2006 at Strasbourg University Hospital (France) who secondarily complained of diplopia. Patient history, scleral buckling type, and early and late postoperative complications were described.

Results: Among 821 patients who underwent scleral buckling, 12 developed diplopia lasting more than 3 months. Six of the scleral buckling operations were vertical, three horizontal, and three oblique. Examination of the 12 patients showed seven cases of hypertropia, two cases of hypertropia associated with esotropia, one case of hypertropia with exotropia, and two cases of exotropia. The scleral buckle was removed in first intention in all 12 patients; binocular single vision was restored in six cases. Secondarily, prism correction restored binocular vision in three additional patients. Strabismus surgery was necessary for the remaining three patients.

Discussion: Diplopia following retinal detachment usually responds to simple measures. In our study, the removal of the buckle restored binocular vision in the majority of cases, a prism correction was useful for the remaining patients. Strabismus surgery was often very efficient.

Conclusion: Diplopia complicating scleral buckling generally responds to simple treatments that can eliminate a handicapping functional deficit.