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Primary Retinal Detachment

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134<br />

6 Minimal Segmental Buckling With Sponges and Balloons<br />

To analyze whether this slight decrease in visual function could be<br />

due to the presence of the segmental buckle or to secondary complications,<br />

the visual acuity of the fellow eyes was compared with the<br />

operated eyes at all intervals. There was no significant difference<br />

(P=0.079) in visual acuity over the 15 years. In this context, the<br />

data of Slataper are of value [50]. He had plotted the visual acuity<br />

of 17,349 individuals as a function of age and found that after the<br />

age of 60, a linear decrease of 0.07 lines per year on the Snellen<br />

chart occurs and that this decrease is age-dependent. There is no<br />

statistically significant difference between the observed decrease<br />

over the years, determined by Slataper, and the one in the analyzed<br />

operated eyes.<br />

Thus, postoperative visual acuity (even when including the<br />

surgical failures) with a maximum of 0.6 at 1 year after surgery had<br />

only slightly decreased to 0.5 during 15 years. There was no statistically<br />

significant difference from the course in the fellow eyes over<br />

the ensuing 15 years; it was due to aging.<br />

Series 2 through 5, with a combined total of 710 retinal detachments<br />

treated with segmental sponges or balloons without drainage,<br />

provide useful data on postoperative visual acuity and its<br />

course over 2 years (Table 6.4) to 15 years (Fig. 6.15). The long-term<br />

postoperative visual acuity of the eyes treated with sewed-on buckles,<br />

limited to short segmental sponges to close the retinal breaks,<br />

confirm that minimal segmental buckling has no negative effect on<br />

long-term visual function.<br />

Disadvantages of <strong>Primary</strong> Minimal Segmental Buckling<br />

Without Drainage<br />

Disadvantages of primary minimal segmental buckling without<br />

drainage are as follows:<br />

1. Preparation for a minimal buckle operation, limited to the<br />

break and without drainage, requires extensive preoperative

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