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J.J. Brown, H. Wafapoor; A Surgical Technique To Avoid Fragmentation Of Episcleral Miragel Buckle Elements During Removal . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4227.
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To describe a surgical technique that aids the removal of episcleral Miragel buckles by preventing fragmentation of the buckle.
Retrospective analysis of five eyes all with a prior history of Miragel scleral buckling procedures and subsequent deterioration of the scleral buckle(SB) necessitating surgical removal. The surgical technique began with incising the conjunctiva directly over the encircling SB in each of the four quadrants between the rectus muscles using Wescott scissors. The capsule surrounding the Miragel buckle was then visualized and incised. A cotton tipped applicator was then placed directly on the SB in one of the quadrants and firm pressure applied. One quarter of the SB was then expressed from the incision in the adjacent quadrant. These steps were repeated in each of the other three quadrants to complete the removal of the scleral buckle.
Using the described technique all five of the Miragel scleral buckles were removed completely with small fragmentation of the Miragel buckle avoided. There were no surgical complications
This method of removal of Miragel scleral buckles has proven beneficial by preventing the fragmentation of the buckle during removal. Preventing fragmentation during removal speeds the overall operative time and would also likely decrease surgical complications that can result from sharp dissection required to remove fragmented pieces of the scleral buckle.
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