Primary Retinal Detachment

Are Encircling and Drainage Still Popular Methods? 43
Fig. 3.5. Subretinal blood after drainage. It is parafoveal, but vision remained
poor
Are Encircling and Drainage Still Popular Methods?
In light of the above tales of both success and morbidity, are
encircling and drainage still done? The short answer is that encircling
with drainage, as opposed to minimal segmental buckling
without drainage [36], requires less-accurate meridional localization
of all breaks, is subsequently somewhat easier to do, and
works at the short-term risk of hemorrhage and long-term risk of
choroidal ischemia.
In more recent (1982–2002) clinical series on scleral buckling
[15, 26, 37, 38], encircling was practiced in 43–100% (average 74%)
and was combined with drainage in 72–85% (average 78%) of total
cases. Gas was injected in 26–32% in two series; this procedure is
also known as “pneumatic buckle” [15, 37]. Primary success ranged
from 78% to 96% (average 85%). Obstacles to success were
aphakia/pseudophakia, whereas the main benefit of encircling
relative to alternate procedures was found to be the low incidence
of secondary tears (1.3% versus 18–20%) [15].