Primary Retinal Detachment

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6 Minimal Segmental Buckling With Balloon
Fig. 6.13. Two separate detachments with only one questionable break.
a There is a superior detachment with two lattice degenerations and
“erosions”. A most likely break is located at 11:00 with obvious vitreous
traction at the lateral edge of lattice degeneration. The convex pigment
demarcation line beneath the superior detachment posterior to the lattice
degeneration indicates that a full thickness break might be present at
11:00. In the inferior detachment, there is a questionable tear at 8:00 at the
lateral edge of lattice degeneration. When lying the patient flat, no communication
between the two separate detachments was detected. b After
insertion of a diagnostic balloon (1 day) beneath the suspected break at
11:00: The break and the entire lattice is surrounded with cryopexy lesions.
The superior retina had attached and the inferior detachment diminished
in size, indicating that its fluid is originating from the superior break now
being tamponaded. c After balloon operation (10 days): The balloon was
withdrawn after 8 days when the cryopexy lesions were pigmented. The
lattice degeneration at 12:00 was surrounded with laser lesions. There is
still residual fluid around the inferior lattice degenerations. d After balloon
operation (4 weeks): The residual fluid had disappeared. No further
treatment was added