A Narrow Silicone Sponge to Close a Wider Retinal Tear: The Open-Book Technique of Scleral Buckling

Abstract

The authors describe a modified technique for scleral buckling by which a wide retinal tear can be closed with a relatively narrow buckle. An incomplete cut on the silicone sponge can be made so that the halves are connected to each other by a narrow strip of material and opened like a book when buckling. Using this open-book technique, silicone sponges can be used to close horseshoe-shaped retinal tears of one to two times the width of available silicone sponges. This technique was used in four eyes with excellent anatomical results, and no complications could be attributed to the surgical technique. This technique provides an alternative treatment strategy for retinal detachment with relatively wide retinal tears.

Scleral buckle infection with Alcaligenes xylosoxidans

“…[2] In this technique, an incomplete cut was made along the longitudinal axis of a silicone sponge, which then can be opened like a book and buckled onto the sclera by matrix sutures in the corresponding position of the retinal tear. During the past 3 years, we have used this technique in six eyes, and this is the first serious buckle-related complication.…”

“…She had a past history of ocular surgery for rhegmatogenous retinal detachment in the right eye 2.5 years earlier, consisting of cryopexy and scleral buckling using the open-book technique. [2] On examination, her visual acuity was 20/50 in the right eye and 20/25 in the left eye. Severe follicular hypertrophy and mucopurulent discharge with pseudomembrane formation in the right palpebral conjunctiva were noted.…”

“…We presented an open-book technique of scleral buckling, a modified technique of scleral buckling using a narrow buckle to close a wider retinal tear. [2] Now, we report a case of open-book scleral buckle infection with A. xylosoxidans .…”