Circumferential Buckling on Equator: III. Retinal Dialysis up to 180 Degrees

ABSTRACT

The purpose of this paper is to describe the most appropriate surgical techniques in the repair of retinal dialyses up to 180 degrees. In this sesies, silicon bands were used as an encircling element with conserved sclera implant. Perhaps a circling buckle will decrease a traction of vitreoretinal pathology located in equatorial area and reduce the rate of recurrence in patients who are exposed to an active life with repeated minor traumata. Retinal dialyses up to 90 degrees have been treated with a shorter and higher implant because the ends stretch the retina circumferentially by the sloping ends of the buckle. All of the 37 eyes with a dialysis up to 90 degrees and a clinical retinal detachment maintained successful reattachment of the retina. In retinal dialyses between 90-180 degrees a long, broad and lower implant was applied. The sclera was lamellarly dissected into two flaps extending approximately one hour of the clock beyond each end of the tear. In five of ten eyes with giant break, the posterior edge of tear could be settled on the underlying pigment epithelium during slight compression on sclera with Eisner's contact lens ane in five eyes the flap was everted and immobile. The retina was intentionally incarce rated on the buckle when the flap was everted and immobile. By this technique a giant dialysis could be transformed into two neighbouring dialyses up to 90 degrees. Of those eyes without everted three out of five were successfully reattached and of those eyes with an everted immobile flap four out of five eyes. 93.6% of the consecutive 47 cases of dialyses with a clinical retinal detachment were successfully reattached. If the patient with a postequatorial large horseshoe-shaped tear and a case with chorioretinohyalopathy and neovascularization of the chamber angle were excluded, the success rate rose to 97.9%. Three cases of the successful reattachment required a second operation. This report reviewed the results of the technique in the treatment of retinal detachment caused by dialyses up to 180 degrees. In a previous study, the management yielded a 95.7% success rate in retinal detachment caused by equatorial break operated by one of us. No comparison can be made between the success rate of these two types of tears (P>0.05) since all gave consistently excellent result.