Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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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