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Primary Retinal Detachment

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118<br />

6 Minimal Segmental Buckling With Sponges and Balloons<br />

3. An old detachment with a pigment demarcation line and an<br />

intraretinal cyst (Fig. 6.12); here too, a balloon buckle sufficed.<br />

4. The balloon can also be used as a diagnostic tool to test for<br />

presence of only one break in two separate detachments<br />

(Fig. 6.13).<br />

5. Or, the balloon can be used even in a detachment up for reoperation<br />

with PVR stage C2 (Fig. 6.14).<br />

Why Is the Balloon Operation so Difficult to Accept?<br />

The premises for success are: (1) a maximum of preoperative diagnostics,<br />

so as not to overlook a break; (2) a precise localization<br />

of the break at the table without prior drainage; (3) marking the<br />

detached break on mobile conjunctiva (in contrast to the segmental<br />

sponge operation, in which the break can be marked precisely<br />

on the sclera); and (4) localization of a highly elevated break on a<br />

yet slightly indenting parabulbar balloon in presence of a bullous<br />

detachment with a pronounced and misleading parallax.<br />

Advantages of the Balloon Operation<br />

Advantages of the balloon operation are as follows:<br />

1. The surgery is short, ranging between 10 min and 20 min<br />

2. The anesthesia is topical or subconjunctival<br />

3. The recovery of vision is fast and optimal<br />

4. The last complications of segmental buckling are eliminated,<br />

i.e., there is no buckle infection, because the balloon is removed,<br />

and no diplopia. Diplopia, if present, disappears after the balloon<br />

is withdrawn.

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