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Dimitra Skondra, Demetrios Vavvas; A Novel Surgical Technique For Encircling Scleral Buckle Surgery For Primary Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4602.
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During encircling scleral buckle placement, the ends of the element/band are tightened in order to achieve a shortened radius of the eye at the place of the buckle. The determining factor for how much the band should be tightened is usually estimated subjectively by the height of the buckle on indirect ophthalmoscopy and can be difficult to be taught early on to trainees. Here we describe a novel encircling scleral buckle technique that simplifies and standardizes the achievement of reproducible buckle height of 1 mm that is objective and easy to be taught.
According to geometry rules, the circumference of the globe is 2πR where R is the radius of the globe and π the standard value of 3.14. If buckle height is 1mm, which we consider to be an ideal buckle height, the new circumference of the globe should be 2π(R-1mm). The difference between the two circumferences is always 2π=6.28mm independently of the initial radius of the globe. To make easy of the calculations and because we usually measure cord length we simply shorten the encircling buckle element by about 5mm after cutting the two ends flush. Subsequently we directly appose and tie the ends with three interrupted 5.0 nylon sutures. We secure the element in place with a double pass mattress suture.
Five patients, 3 males and 2 females with primary retinal detachment underwent encircling buckle placement using this novel technique. The average age was 27 years old and mean follow up time was 2 years. All five patients had good buckle height postoperatively and in four out of five patients the retinal detachment resolved and retina remained attached during the follow up period.
This novel encircling scleral buckling technique successfully achieves an ideal postoperative scleral buckle height in a reproducible and standardized fashion using objective measurements. This is easier to be taught to trainees.
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