Primary Retinal Detachment

10
1 The History of Retinal Detachment Surgery
Fig. 1.3. Charles L. Schepens. (Reproduced with permission; Wilkinson
CP, Rice TA (1997) Michels retinal detachment, 2nd edn. Mosby St. Louis
MO. pp 241–333 [10])
After applying surface diathermy to the full-thickness sclera over
the break, he sutured a polyviol material to the sclera. The eye wall
was indented at the area of the break so that the retina would appose
the RPE and close the break. In 1956, he reported his experience
with 515 consecutive patients with an 83.3% successful reattachment
rate [85]. He did not believe that subretinal fluid needed
to be drained and, if the subretinal fluid was not absorbed by day 4,
he recommended re-operation.Schepens in 1951 performed the first
scleral buckling procedure with an exoplant in the United States
(Fig. 1.3) [86–93]. In 1956, he described the use of an encircling
polyethylene tube that was placed under the flap of a lamellar
scleral dissection [88]. Using the indirect ophthalmoscope introduced
by Schepens, he and his colleagues were able to identify and
meticulously localize the posterior edge of retinal breaks [94]. The