Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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104<br />
6 Minimal Segmental Buckling With Sponges and Balloons<br />
found that there is one break in 50% of detachments, two breaks in<br />
30%, and three or more breaks in 20%. Thus, after a meticulous<br />
preoperative and intraoperative search for the break, in about 50%,<br />
not more than one break has to be buckled. In addition, in general,<br />
multiple breaks are not distributed over the entire retinal circumference<br />
of the eye, but tend to be located within the quadrant of the<br />
primary break.<br />
Optimum segmental buckling aims to fit the various sizes<br />
and configurations of retinal breaks. There can be three or four<br />
segmental buckles to circumvent a cerclage. The complications<br />
of a cerclage tend to be: anterior segment ischemia, hypertension<br />
or hypotension, uveitis, decreased retinal and choroidal blood<br />
flow and eventual unilateral pigmentary dystrophy, constricted<br />
visual field,reduction in two-point discrimination,and diminished<br />
retinal activity or a reduced amplitude of the electroretinogram<br />
[27–32].<br />
<strong>Detachment</strong>s with multiple breaks and even with proliferative<br />
vitreoretinopathy (PVR) grade C1–C2 can be treated with segmental<br />
buckling and without drainage (Figs. 6.4–6.8). The segmental<br />
buckles may consist of radials, short circumferentials, or a combination<br />
of both, but without a cerclage.