—We value the comments of Drs Tornambe and Hilton relating to their experience with induced refractive changes and strabismus after scleral buckling surgery within the Pneumatic Clinical Trial.1 They found that encircling scleral buckling elements were associated with at least 1 diopter of induced myopia in 68% of such cases. This appears to be consistent with the findings in our study,2 but these results are not presented in enough detail to allow more direct comparison.The Pneumatic Clinical Trial series included two of five patients with postoperative diplopia following a "segmental" procedure. This contrasts with our related study in which none of 28 eyes that did not undergo an encircling procedure developed postoperative strabismus.3 In the Pneumatic Clinical Trial 95% of cases randomized to scleral buckling underwent an encircling procedure. Our experience does not include encircling this frequently and may explain this disparity. Also, one
Smiddy WE, Michels RG. Pneumatic Retinopexy and Buckling-Reply. Arch Ophthalmol. 1990;108(3):319. doi:10.1001/archopht.1990.01070050016004
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