06.02.2013 Views

Primary Retinal Detachment

Primary Retinal Detachment

Primary Retinal Detachment

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

Complications of Encircling 39<br />

Fig. 3.3. Pathological specimen of an enucleated eye with a large buckle<br />

which had caused motility problems<br />

purse-string syndromes as well as short- and long-term effects of<br />

choroidal ischemia and reduced pulse amplitude [17, 18].<br />

Some of these events can be controlled with careful technique.<br />

Conjunctival scarring and chronic dry eye can be reduced by<br />

meticulous attention to Tenon’s capsule and careful dual layer closure.<br />

(It is unfortunate that closure is at the end of a challenging<br />

and tiring operation and is often delegated without much supervision).<br />

Strabismus can be reduced by careful handling of orbital tissues<br />

and muscle retraction and by choosing small instead of large<br />

buckles [19–21] (Fig. 3.3).<br />

Meticulous restoring of the anatomy will limit scarring. Motility<br />

can be improved by postoperative ocular exercise. Erosion and<br />

string syndrome can be avoided by limiting constriction to 10%<br />

[22] (Fig. 3.4). Overzealous constriction (“high and dry”) can be<br />

corrected later by cutting the band. More difficult post-surgical<br />

judgements are presented by insidious choroidal ischemia and<br />

reduced pulse amplitude [17, 18]. Typically, the retina is attached<br />

and the vision is good yet there may be mild chronic irritation/

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

Saved successfully!

Ooh no, something went wrong!