SCLERAL ECTASIA IN RHEGMATOGENOUS RETINAL-DETACHMENT

Objective: To determine the relation between retinal tears and scleral ectasia. Design: Prospective study. Setting: University-based referra l practice in Montreal. Patients: Fifty-seven consecutive patients wit h primary rhegmatogenous retinal detachments undergoing scleral buckli ng surgery. Patients with a history of trauma or previous cryotherapy, laser treatment or other vitreoretinal procedures were excluded. Fift een patients with diabetes mellitus undergoing primary vitrectomy and prophylactic scleral buckling for nonclearing vitreous hemorrhage cons tituted the control group. Outcome measures: Presence of scleral ectas ia, visual acuity, refractive error. Results: Thirty-one of the study patients were phakic and 26 were aphakic or pseudophakic. Fifteen (48. 4%) of the phakic patients were found to have scleral ectasia, compare d with six (23.1%) of the aphakic/pseudophakic patients and two (13.3% ) of the control patients (p < 0.05, chi(2) test). The most frequent l ocation of ectasia was the superotemporal quadrant. Retinal tears occu rred in the same quadrant as scleral ectasia in 12 (80.0%) of the phak ic patients. Conclusions: Scleral ectasia may be causally related to r hegmatogenous retinal detachment in certain cases.