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J.-M. Perone, R. Alami, R. Jlaiel, M. Casillas Gil, P. J. Bertaux, M. Al Saoud, A. Popovici, G. Breazu; Surgery of Retinal Detachment by External Way With Cryo-Application and Soft Equatorial Scleral Buckling Without Suture: Retrospective Study About 35 Cases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5243.
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© ARVO (1962-2015); The Authors (2016-present)
The authors report their experience of the treatment of rhegmatogenus retinal detachments (RD), by exclusive external way, with cryoapplication and equatorial scleral buckling without suture.
The study is retrospective, concerns 35 eyes, successively operated by the same surgeon between Jan 05 and Nov 07. The reserved cases were simple RD, without vitreoretinal hight shrinkage, without previous retinal surgery or history of complicated cataract . The analyzed data contain: sex and age, degree of myopia, area of RD, location of the tears, duration of evolution, time of intervention, VA before and after operation, time of recession, possible complications, and rate of anatomical success after surgery. The interventions were realized under general anesthetic, with cryoapplication of the retinal tears by means of a slit-lamp, with scleral buckling by fine silicone band of 2/0.75mm (labs FCI, Paris, France), underlain by intrascleral shrouds (2 shrouds by quadrants) and tied up by means of a slive in temporal superior, without any suture. A draining of subretinal liquid with needle before final collision by a sterile air bubble was realized in a systematic way.
The average age of the operated patients was of 56.68 years (12 / 83 years), it was about men in 68.57 % of the cases, which had an initial average myopia of -5.12 D (-1 /- 20) and a posterior chamber IOL in 31.42 % of the cases. The average post follow-up operating was of 15 months (1 / 36 months), the average evolution of the RD before surgery of 16.77 days (1 / 60 days), with macular achievement in 60 % of the cases. The tears were respectively of superotemporal situation in 57.14 % of the cases, superonasal in 40 %, lower temporal in 17.14 % and lower nasal in 5.71 %. The duration of average intervention was 46.14 mn (35 / 75 mn), with an anatomical success and a retinal reapplication after a single intervention in every cases. The preoperative VA was on average equivalent to 36/200 and in postoperative to 80/200. The listed complications was in one case an impression of diplopia, in another one a persistent macular oedema and for the last one a macular pucker.
The surgical technique described by external way with cryoapplication and equatorial scleral buckling without suture, seems to be completely adapted for the coverage, in first intention, of simple rhegmatogenus RD. It has the advantage to be according to the authors, simple, very effective, easily reproducible, fast and not expensive, without described major complication.
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