INTRACTABLE PAIN AND DIPLOPIA AFTER SCLERAL BUCKLE SURGERY

Hossein Nazari, Geoffrey Emerson, Peter H. Tang

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose:To report a case of early postoperative scleral buckle slippage because of the dehiscence of scleral belt loop tunnels.Method:Case report.Results:A 54-year-old woman presented with painful diplopia after a combination pars plana vitrectomy and scleral buckling procedure. Ocular movements were limited. Forced duction testing was restricted in all directions. Anterior slippage of the silicone band was suggested on computed tomography (CT) scans and was confirmed with surgical exploration. During surgery, it was found that thin-roofed scleral belt loop tunnels were dehisced in three quadrants leading to anterior slippage of the buckle. The displaced buckle was removed. Diplopia and pain resolved, and ocular motility improved immediately afterward. The retina remained attached at six months follow-up. A supplemental video summarizes the surgical findings and postoperative results.Conclusion:Spontaneous dehiscence of scleral belt loops may occur in thinly dissected scleral tunnels. Painful eye movement, diplopia, and a positive forced duction test should raise suspicion about a displaced scleral buckle. A CT scan may help with the diagnosis. Early diagnosis and immediate surgical intervention are needed to minimize patient discomfort and to improve long-term ocular motility.

Original languageEnglish (US)
Pages (from-to)41-43
Number of pages3
JournalRetinal Cases and Brief Reports
Volume17
Issue number1
DOIs
StatePublished - Jan 1 2023

Bibliographical note

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • belt loop scleral tunnel
  • diplopia
  • retinal detachment
  • retinal surgery
  • scleral buckle
  • slipped buckle
  • slipped scleral buckle

PubMed: MeSH publication types

  • Case Reports
  • Journal Article

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