Strabismus following Retinal Detachment Surgery

The incidence of strabismus following retinal detachment surgery and the factors influencing it are not well established. We examined the records of 461 patients who underwent 500 retinal detachment operations in which strabismus occurred in 34 patients (6.8%). Factors found to significantly increase the incidence of strabismus included multiple retinal detachment operations, the use of an encircling element, the placement of a segmental buckling element beneath a rectus muscle, and the use of large or multiple segmental buckling elements. Factors that did not influence the incidence of strabismus included the placement of segmental buckling elements away from all four rectus muscles, muscle disinsertion, patient age, and preoperative or postoperative visual acuity. Specific causes of strabismus included surgical adhesions and disruption of the region of the superior oblique tendon insertion. Management of the resultant strabismus included judicious neglect, occlusion, prisms, and surgery.