Corneal Biomechanical Response Alteration After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment

Purpose: To compare the corneal biomechanics of eyes that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) with those of fellow eyes (fellow eyes) and to further investigate the effects of SB on intraocular pressure (IOP) values. Design: Retrospective, fellow-eye matched cohort study. Methods: A total of 18 consecutive patients (11 males and 7 females) treated with SB for RRD in 1 eye were enrolled. Goldmann applanation tonometry was used to measure IOP. Biomechanical properties of the cornea were investigated by using the Ocular Response Analyzer (ORA) (Reichert Instruments) for the calculation of corneal resistant factor (CRF), corneal hysteresis, Goldmann-correlated IOP, and corneal-compensated IOP. Customized software was used for analysis of the ORA infrared and pressure signals, and a significance threshold was set to a P value of. 05. Results: Operated eyes (OEs) showed significantly lower values of corneal hysteresis and CRF than fellow eyes (9.0 ± 1.8 vs 10.1 ± 1.8 mm Hg, respectively; P < .001; 10.0 ± 2.2 vs 10.9 ± 2.2 mm Hg; P < .001). GAT was significantly lower than corneal-compensated IOP in OEs (18.1 ± 4.9 vs 19.8 ± 4.8 mm Hg, respectively; P = .022) but not in fellow eyes. The second applanation event (A2) took place earlier in time, and the cornea was moving faster during A2 in the OEs than in the fellow eyes. Conclusions: SB for the treatment of RRD affects corneal biomechanical response, likely due to a less compliant sclera that limits corneal motion and reduces energy dissipation, reflected in a lower corneal hysteresis. This has potentially meaningful clinical implications as the accuracy of the measurement of IOP values may be affected in these eyes.