Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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136<br />
6 Minimal Segmental Buckling With Sponges and Balloons<br />
1. The procedure is extraocular.<br />
2. It is performed under local or topical anesthesia.<br />
3. It can be done in an outpatient setting.<br />
4. It can be performed on a low budget, because it uses less operating<br />
time (rarely more than 45 min and 10–20 min with the<br />
balloon), inexpensive equipment, and few trained personnel in<br />
attendance. For the surgery itself, no costly disposable instruments<br />
or expensive intraocular tamponades are required.<br />
5. It can be applied for superior and inferior breaks.<br />
6. There are, except for a rare choroidal in 0.3%, no intraocular<br />
complications, such as: secondary glaucoma, cataract, intraocular<br />
hemorrhage, intraocular infection, incarceration of retina<br />
or vitreous, or iatrogenic tears, because the procedure is extraocular.<br />
7. No postoperative head positioning of the patient is required<br />
during the day or at night while asleep, and traveling by airplane<br />
is not restricted because intraocular gas is not injected.<br />
8. The primary attachment rate of 1,462 primary retinal detachments<br />
treated with minimal segmental buckling and without<br />
drainage is 91% and after reoperation 97.4% over 2-year<br />
follow-up.<br />
9. The low rate of redetachment: over a 2-year follow-up the rate<br />
of redetachment in the 1,462 eyes treated with minimal segmental<br />
buckling averages 0.6% per year (series 1 to 5) and over a<br />
follow-up between 2 years and 15 years (series 2) 0.5% per year.<br />
10. The recovery of visual acuity is optimal after minimal segmental<br />
buckling without drainage. In the series of 107 detachments<br />
with a mean preoperative visual acuity of 0.3, the mean value at<br />
1 year is 0.6 and 0.5 at 15 years. The observed slight decrease<br />
over years is an effect of aging and not of secondary complications.<br />
11. This low rate of intraoperative and postoperative complications,<br />
combined with optimal long-term visual results, is of benefit to<br />
the elderly patient and to the decreasing financial resources.<br />
This becomes more relevant because new treatments for various