Dr.PRACHI AGASHE

, Dr.Ashish Doshi, DR. KALYANI DIWALE

Abstract

21-year-old male presented with outward and downward deviation of right eye 5 years following scleral buckle surgery done for retinal detachment following blunt trauma 6 years back. On examination, right eye had complete aniridia and aphakia with pseudoptosis with no light perception. Krimsky test revealed 50 pd exotropia,16 pd hypotropia with limited adduction and limited elevation in adduction with downshoot in adduction suggestive of Brown’s syndrome. FDT was positive for SO. After conjunctival incision,recti were found to be displaced, buckle was found encapsulated in a pseudocapsule. Superior oblique was found anteriorised at 4 mm from SR insertion. SO tenectomy with LR recession and MR resection was done. 3 months postoperatively patient was near orthophoric with minimally limited elevation in adduction.

Squint surgery in case of scleral band/buckle can be challenging due to change in the position of extraocular muscles and fibrosis but can be managed well with good result.