06.02.2013 Views

Primary Retinal Detachment

Primary Retinal Detachment

Primary Retinal Detachment

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

Functional Results 131<br />

to either side of the sponge. When a very anterior circumferential<br />

buckle was needed, it was placed external to the muscle [44]. Most<br />

important were daily ocular motility exercises during the first<br />

postoperative week to counteract the development of adhesions<br />

around the muscle. This was done independent of the state of the<br />

retina.As a result, no sponge had to be removed because of diplopia.<br />

In the fifth series (n=500), a temporary balloon buckle was applied,<br />

which was removed after 1 week. In this series, there was no<br />

buckle infection or exposure. Diplopia was sometimes present<br />

when the balloon was in place, but diplopia remitted in all eyes<br />

within hours after the balloon was removed.<br />

Functional Results<br />

Since the end of the 1960s, detachment surgery has been concentrating<br />

not only on anatomical results, but also on visual function<br />

[45–49] – both short-term recovery after surgery and long-term<br />

visual acuity.<br />

In the first series, visual function was not described. In the<br />

remaining four series, treated with sponges or balloons, the mean<br />

visual acuity was 0.67 after 2 years (Table 6.4). The two questions<br />

that arise are: (1) Would visual acuity decline over years? (2) Would<br />

the presence of a segmental buckle over years cause a secondary<br />

deterioration of visual function?<br />

These pending questions can be answered by the second series of<br />

107 primary retinal detachments treated by minimal segmental sponge<br />

buckle(s) without drainage and with a complete follow-up of 15 years<br />

[40]. The mean preoperative visual acuity was 0.3; it improved to<br />

0.5 during the first 6 months after surgery, and reached a maximum<br />

of 0.6 at 1 year. The increase was statistically significant (P

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!