Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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Minimal Segmental Buckling With Sponges or Balloons 125<br />
Minimal Segmental Buckling With Sponges or Balloons Without<br />
Drainage: A Medline Analysis<br />
Materials and Methods<br />
A Medline search was made of all reports that were identified by<br />
the search terms “retinal detachment,” “segmental buckling,”<br />
“minimal extraocular surgery,” and “nondrainage.” Reports published<br />
in English, German, Italian, French, Spanish, and in some<br />
East European journals were reviewed and analyzed. The majority<br />
of reports did not contain homogenous data suitable for the analysis.<br />
Many included both complicated and uncomplicated detachments,<br />
primary detachments and reoperations, or no preoperative<br />
characteristics. In many series, primary segmental buckling was<br />
combined with a cerclage. The buckling was performed with or<br />
without drainage of subretinal fluid. <strong>Primary</strong> segmental buckling<br />
was sometimes combined with an injection of air, an expanding<br />
gas, or silicone oil.<br />
After excluding these reports, an analysis was made of a relatively<br />
homogenous series of mostly primary retinal detachments,<br />
some with preoperative PVR stage C1–C2. The primary procedure<br />
in all eyes was minimal segmental buckling without drainage of<br />
subretinal fluid. The analysis consists of five reported series with a<br />
combined total of 1,462 retinal detachments [26, 37, 39–42].<br />
The preoperative characteristics of the 1,462 primary retinal<br />
detachments were: aphakia/pseudophakia in 8.3% and preoperative<br />
PVR stage C1–C2 in 2.9% (Table 6.1). All operations were done<br />
under local anesthesia. Coagulation was limited to the area of the<br />
break(s) and performed with intraoperative cryopexy under ophthalmoscopic<br />
control or with laser coagulation on a subsequent<br />
day after the break was attached. The buckle was limited to the area<br />
of the break(s) and was obtained with an elastic silicone sponge or<br />
a temporary balloon. Subretinal fluid was not drained in any eye.<br />
Some of the detachments treated are represented in Figs. 6.4–6.13,<br />
recruited from series 2 and 5. All patients were mobilized after
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