Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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Reasons for <strong>Primary</strong> and Final Failure 129<br />
detachments, primary retinal attachment was obtained in 1,325<br />
eyes or in 91%.After reoperation, attachment resulted in 97.4% and<br />
persisted during a 2-year follow-up (Table 6.3).<br />
Reasons for <strong>Primary</strong> and Final Failure<br />
Missed Breaks<br />
With minimal segmental buckling, if a break is missed and<br />
drainage not performed, the retina will not become attached at any<br />
time – not at the table, nor spontaneously in the days after surgery.<br />
A missed break was the cause of primary failure in 62 eyes or in<br />
4.2% and, after reoperation, in 12 eyes or in 0.8% (Table 6.3).<br />
Inadequate Buckles<br />
The second most frequent cause of primary failure was an inadequate<br />
buckle, which was present in 51 eyes or in 3.5%. This was<br />
easily corrected by either moving the buckle or enlarging it. After<br />
reoperation, the buckle was no longer a reason for final failure.<br />
Proliferative Vitreoretinopathy<br />
Despite the fact that PVR stage C1–C2 was already present preoperatively<br />
in 43 eyes or in 2.9% of the 1,462 detachments treated, it<br />
was the cause of primary failure in only 20 eyes (1.4%) and, after reoperation,<br />
the cause of final failure in 28 eyes or in 1.9%.<br />
Thus, the presence of PVR did not preclude applying minimal<br />
segmental buckling with sponges or balloons without drainage. By<br />
omitting drainage, a breakdown of the blood–aqueous barrier was<br />
eliminated. By performing cryopexy and buckling with a minimum<br />
of trauma to these vulnerable eyes, a progression of PVR<br />
could be circumvented.