SUPRACILIARY EFFUSIONS AND CILIARY BODY THICKENING AFTER SCLERAL BUCKLING PROCEDURES

Purpose: The purpose of the study was to use ultrasound biomicroscopy to identify and quantify changes in anterior segment parameters after scleral buckling procedures. Methods: Ultrasound biomicroscopy was use d to examine 15 patients with retinal detachment within 1 week before and after surgery. Quantitative measurements were performed of anterio r chamber depth, supraciliary effusion depth, ciliary body thickness, and angle opening. Results: Supraciliary fluid was present after surge ry in 12 patients (80%). Average supraciliary fluid depth was 0.16 +/- 0.13 mm. Ciliary body thickness measurements at a point 2-mm posterio r to the scleral spur increased after surgery in all patients an avera ge of 0.15 +/- 0.10 mm. There was a strong correlation between ciliary fluid levers and change in ciliary body thickness (r = 0.742, P < 0.0 1). Anterior chamber depth decreased after surgery in 14 patients (93% ). A decrease of angle opening of greater than 5 degrees was rioted in 11 patients (73%). In all of these 11 patients, the ciliary body and iris root were considered to be rotated anteriorly. Six (55%) of 11 of these patients showed anterior bowing of the iris, indicating pupilla ry block. Complete angle closure occurred over one to three quadrants in three patients, but none of these patients had complete angle closu re or glaucoma. Conclusions: Supraciliary effusions and ciliary body t hickening are common after scleral buckling procedures and can produce conditions conducive to angle closure. Angle narrowing occurs through a combination of direct anterior iris rotation and induced pupillary block.