Effect of Scleral Buckling Surgery on Accommodation Amplitude: Compared with normal fellow eyes

Purpose: To demonstrate weather scleral buckling surgery can increase accommodation amplitude in patients.Methods: Non-randomized, prospective, double masked clinical trial in which the fellow eye of all patients served as control. Results: Seventy- four eyes of 37 patients were studied. Thirty- nine eyes of 37 patients underwent scleralbuckling surgery due to retinal detachment. Two patients underwent bilateral surgery due to bilateral retinal detachment. Thirty six of 39 operated eyes (92.3%) were phakic and 3 eyes were pseudophakic. In phakic eyes there was a statistically significant more accommodation amplitude in scleral buckled eyes in comparison with their fellow eyes 1 month (P value: 0.002) and 3 months (P value: 0.001 ) post- operatively; However the amount of increase in accommodation amplitude was not clinically significant (0.99 diopters one months and 1.17 diopters 3 months post-operatively). This increase in amplitude of accommodation was not statistically significant in pseudophakic eyes; However, this can be due to limited pseudophakic cases and low power of this study in this subgroup. Patients who underwent encircling band surgery did not show significantly more accommodation amplitude change both 1 and 3 months after surgery in comparison with segmental sponge placement (P value 0.37 and 0.38 respectively). However, both buckle types showed statistically significant more AA in operated eye in comparison with their fellow virgin eye. In segmental sponge surgeries patients with inferior quadrants sponge fixation showed significantly higher accommodation amplitude change in comparison with superior quadrants sponge. Patients with better post-operative best corrected visual acuity (BCVA) and age under 40 showed more increase in accommodation amplitude. There was a negative correlation between buckle distance from limbus and accommodation amplitude (P value: 0.04). Conclusion: Scleral buckling surgery can increase accommodation amplitude in phakic retinal detachmentpatients. However, the amount of increase is limited.