Peritomy-sparing scleral buckle

Abstract

Abstrac Purpose To introduce a modified technique for encircling circumferential scleral buckling without peritomy thorough a small conjunctival opening for the repair of uncomplicated rhegmatogenous retinal detachment (RD). Methods This technique was performed in 10 eyes of 10 patients with primary rhegmatogenous RD who underwent encircling circumferential scleral buckling without peritomy. Transconjunctival traction sutures were placed in four rectus muscles. After transconjunctival location of the retinal break, a 5- to 6-mm radial conjunctival incision was performed in 4 quadrants without cutting the limbal conjunctiva–Tenon's capsule. A 240-silicone band in scleral belt loops was used for an encircling circumferential buckle. After drainage and cryopexy, SF6 was used for tamponade. The incision was closed via layered closure only ocassionally. Results Primary attachment success of 100% was achieved by single procedure. The intraoperative and postoperative complications observed included subconjunctival hemorrhage observed in 5 (50%) of eyes. These disappeared in the postoperative period. Conclusions Minimal conjunctival incision in scleral buckle without peritomy can achieve excellent anatomical success in patients with rhegmatogenous RD without distorting ocular surface anatomy. This is the first description of technique preserving corneal limbus anatomy that could convert buckling surgery to more attractive option for retina surgeons.

Intractable Pain and Diplopia After Scleral Buckle Surgery

“…Scleral belt loop tunnels are becoming increasingly popular for securing the encircling band to the sclera. [4][5][6][7] Spontaneous dehiscence of scleral loop tunnels is rare. Fukumoto et al 8 reported a patient who presented with mild foreign body sensation and visible silicone band under the conjunctiva one year after a combined pars plana vitrectomy and SB surgery.…”

“…2,3 The method has recently gained popularity as more SB procedures are performed under microscopy, as a "sutureless" surgery, or using 3D visualization systems. [4][5][6][7] In this method, the encircling buckle material is anchored to sclera through a partial thickness circumferential scleral tunnel that is usually dissected using a crescent knife. Globe perforation through full-thickness None of the authors has any financial/conflicting interests to disclose.…”