Purchase this article with an account.
Yoshiaki Shimada, Masayuki Horiguchi; Encircling Scleral Buckling With Small Posterior Radial Incisions. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4603.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To develop a new surgical procedure of encircling scleral buckling to treat rhegmatogenous retinal detachment (RRD) preserving the anterior conjunctiva-Tenon’s capsule. A peritomy with extensive dissection, conventionally used for encircling buckling, causes massive scarring of the the anterior conjunctiva-Tenon’s capsule on sclera and may hinder future trabeculectomies. The new method utilizes small posterior radial incisions occasionally expanded by the conjunctival retractor (Shimada Y RETINA 2011; Handaya Co. Ltd, Tokyo, Japan).
A 6 to 7 mm radial incision whose distal end is at the conjunctival fonix is made next to each rectus muscle in each quadrant. The incision is expanded by the conjunctival retractor when placing sutures to secure the encircling band or performing a sclerotomy to drain subretinal fluid if needed. The encircling band is passed beneath each muscle from one incision to the next incision.
A complete retinal attachment was obtained in all of 8 RRD eyes with multiple breaks, diffuse lattice degeneration or proliferative vitroretinopathy (PVR). The anterior conjunctiva-Tenon’s capsule was completely preserved except in a case of PVR, treated by the combined encircling-buckle/vitrectomy and silicone oil tamponade.
Encircling scleral buckling through radial incisions of the conjunctiva minimizes surgical invasion and expands our choices for retinal detachment surgery.
This PDF is available to Subscribers Only