REFRACTIVE CHANGES ASSOCIATED WITH SCLERAL BUCKLING AND DIVISION IN RETINOPATHY OF PREMATURITY

Objective: To examine the refractive changes that occur in infant eyes with retinopathy of prematurity (ROP) retinal detachments that are su bjected to scleral buckling and subsequent division of the scleral buc kle. Methods: A retrospective medical record renew of infants with ROP who were managed with an encircling scleral buckle that was subsequen tly divided and who underwent refraction evaluation during and after d ivision of the scleral buckle. Results: Seven eyes from 6 patients had scleral exo-plants placed for stage 4 ROP retinal detachments at a me an postconceptional age of 48 weeks. The mean refractive error in eyes with the scleral buckle was -11 diopters (D) (range, -5 to -25 D) wit h an induced mean anisometropia of -9.5 D. After division of the scler al buckle at a mean of 36 weeks postoperatively, the average post-scle ral buckle refractive error was -5.68 D, resulting in a mean myopic re duction of 5.5 D. Conclusions: Scleral buckling in infants with ROP re sults in large myopic shifts, which art significantly reduced after di vision of the scleral buckle. This highlights the importance of repeat ed refraction testing in infants after placement and division of the s cleral buckle to avoid refractive amblyopia.