A Scleral Imbrication Technique

Lemoine, A; Robison, J. T.; Calkins, Larry L.

doi:10.1001/archopht.1958.00940080253008

Cited by 4 publications

(1 citation statement)

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“…However, even lamellar resection carried a high risk of comorbidity and attempts to achieve the same buckling effect without risking tissue resection were therefore developed. These techniques included Weve's 'reefing' procedures [8], scleral out-folding procedures [9][10][11], scleral in-folding procedures [12][13][14][15][16][17] and scleral shortening by shrinkage with diathermy [18]. With all of these techniques, the main objective was the 'buckling' effect that was produced, which became a key factor in successful retinal re-attachment.…”

Section: A Brief History Of Scleral Bucklingmentioning

confidence: 99%

Scleral buckling—a brief historical overview and current indications

Wang

Snead

2019

Graefes Arch Clin Exp Ophthalmol

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The key to successful management of rhegmatogenous retinal detachment (RRD) is to find and seal all of the retinal breaks, and the two main surgical techniques used to achieve this are scleral bucking (SB) or pars plana vitrectomy (PPV). Techniques for SB have remained mostly unchanged for the last 60 years, whilst PPV techniques and instruments have developed substantially over that time and have greatly contributed to increased success rate for types and configurations of retinal detachments unsuitable or difficult to manage with buckling alone. However, there is a growing dependency to rely on PPVas the sole and only approach for repair of all types of retinal detachment, such that some centres are no longer offering training in scleral buckling. There are also many studies comparing SB with PPV, but many of these lack information on the type, technique or rationale for deployment of the buckle. Many studies deploy the same scleral buckle technique without customising it to the type, position or number of tears being treated. Scleral buckling is not a one-size-fits-all technique. It requires careful patient selection and careful buckle selection and orientation tailored to the tear(s) to ensure success. When used appropriately, it is a simple and highly effective technique, particularly for retinal dialyses, round retinal hole detachments and selected cases of retinal detachment associated with horseshoe retinal tears. There is no doubt that for some more complex cases, such as multiple large breaks, giant retinal tears, bullous detachments and cases complicated by proliferative retinopathy, PPV offers a safer and more effective management. However, SB remains an important and relevant surgical technique, and for the right cases, the results can be superior to PPV with reduced comorbidity.

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