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Abstract
Background: Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition that often requires surgical intervention. The 360-degree band buckle (retinal cerclage) is a modification of scleral buckling that provides circumferential support but may influence intraocular pressure (IOP). Literature remains inconsistent regarding postoperative IOP changes, with limited regional data from Pakistan.
Objective: To compare the pre- and post-operative IOP changes in patients undergoing 360-degree band buckle surgery at Hayatabad Medical Complex, Peshawar.
Methodology: This cohort study was conducted from January to July 2025, enrolling 161 patients (161 eyes) with RRD scheduled for primary 360-degree band buckle surgery. Patients with prior glaucoma, ocular trauma, or systemic conditions affecting IOP were excluded. IOP was measured preoperatively and at one month postoperatively using Goldmann applanation tonometry. Data were analyzed using SPSS-25, with paired t-test applied to compare IOP changes. A p-value ≤0.05 was considered statistically significant.
Results: The mean age was 47.6 ± 9.9 years, with 94 males (58.4%). Right eye involvement occurred in 83 (51.6%) cases. The mean preoperative IOP was 12.3 ± 4.7 mmHg, which significantly increased postoperatively to 15.0 ± 3.1 mmHg (mean rise 2.7 ± 2.2 mmHg, p = 0.045). Elevated IOP (≥21 mmHg) was noted in 29 patients (18.0%), including 26 transient (16%) and 3 sustained (1.9%) cases. Hypotony (≤6 mmHg) developed in 4 (2.5%) patients. Stratified analysis showed no significant subgroup differences (p > 0.05).
Conclusion: 360-degree band buckle surgery results in a significant short-term rise in IOP, mostly transient and manageable. Sustained elevation and hypotony were infrequent, supporting the relative safety of this procedure. Long-term monitoring remains essential to detect late-onset pressure alterations.