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Peiquan Zhao, Haiying Jin, Qi Zhang; Minimal invasive scleral buckling surgery without limbal peritomy for uncomplicated primary rhegmatogenous retinal detachment. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2876. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To introduce and evaluate a novel method of minimal invasive scleral buckling without limbal peritomy for primary rhegmatogenous retinal detachment.
Surgeries were performed under retrobulbar anesthesia. Transconjunctival bridle sutures of the four rectus muscles were performed. The break was localized transconjunctivally with the cryoprobe by indirect ophthalmoscope. A posterior radial or tangential conjunctival opening was made under microscope according to the location of retinal break. After cryotherapy under direct visualization, the location of retinal break was marked on the sclera. Conjunctiva and Tenon’s capsule were retracted using a self-designed retractor. Suturing of the implant (silicone sponges) with minimal size was performed under surgical microscope. The Tenon’s capsule and conjunctiva were finally closed by layer closure. 11 cases with retinal detachment caused either by a single break or by a group of closely placed breaks that did not subtend a retinal arc greater than 1 clock hour; or multiple breaks in different quadrants each with a single or closely spaced retinal breaks subtended an arc no greater than 1 clock hour were treated with this technique.
Average surgical time was 36.5±13.5 minutes. Average length of the silicone sponge was 5.75± 3.55mm. Limbal conjunctiva was preserved in all 11 cases. Retinal reattachments were achieved in all these cases. All buckle positions were correct. No retinal redetachment was occurred within the follow-up. Intraoperative complications sceral perforation, postoperative choroidal effusion, cystoid macular edema, macula pucker, explant extrusion, strabismus, and infection were not observed within the follow-up.
The novel buckling surgery minimizes surgical invasion and preserves health limbal conjunctiva.
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