Sutureless scleral buckle in the management of rhegmatogenous retinal detachment

Shanmugam, P Mahesh; Singh, Tajinder P.; Ramanjulu, Rajesh; Rodrigues, Gladys R; Reddy, Srinivasulu

doi:10.4103/0301-4738.169785

Cited by 9 publications

(9 citation statements)

References 9 publications

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“…Scleral buckling is practiced/taught with decreasing frequency with a preference toward vitrectomy in recent times. 11 This has been attributed to the evolution in instrumentation, wide-field viewing systems and micro-incision cutters in pars plana vitrectomy (PPV). 1 Nevertheless, the adoption of endoillumination and wide-angle visualization systems have rejuvenated Scleral buckling for RRD repair in recent years.…”

Section: Discussionmentioning

confidence: 99%

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Heads up Sutureless Chandelier assisted scleral buckle

AlAkeely

Alageely

2020

American Journal of Ophthalmology Case Reports

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Purpose This study aims to describe chandelier assisted scleral buckle (CSB) using 3D visualizing system in phakic uncomplicated Rhegmatogenous Retinal Detachment (RRD). Methods This technique was performed in 6 eyes of 6 patients with primary rhegmatogenous RD who underwent encircling circumferential scleral buckling with scleral tunnels. Heads up display 3D system was used for visualization and localization of the breaks, and Chandelier Endoillumination was used as a light source was inserted through a 27 G needle sclerotomy 3.5mm from the limbus. A partial-thickness scleral “belt-loop” tunnels in the four quadrants were created using crescent knife angle beveled (2.3 mm in width) to facilitate the smooth passage of the band a 240-silicone band as encircling circumferential buckle. Cryopexy was performed and the incision was closed with cautery or absorbable sutures. Results Primary attachment success of 5 out of 6 and overall success was 100%. No intraoperative or postoperative complications observed although fellows in training performed half the procedures. Conclusions Heads up Sutureless Chandelier assisted Scleral Buckle can achieve excellent anatomical success while improving ergonomics and training. Furthermore, it is a safe procedure with less risk of complications and retinal phototoxicity.

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Section: Discussionmentioning

confidence: 99%

“… 9 Moreover, the sutureless SB helps avoid suture-related complications, inadvertent penetration and infection. 11 …”

Section: Introductionmentioning

confidence: 99%

Heads up Sutureless Chandelier assisted scleral buckle

AlAkeely

Alageely

2020

American Journal of Ophthalmology Case Reports

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“…We believe that peritomy-sparing technique can be employed to treat most primary rhegmatogenous retinal detachments. The sutureless technique also has the advantage of avoiding unnecessarily high and/or irregular buckle, which often can occur when employing sutures 14 . Disadvantages of technique include limited field of view, blind passage of silicone band under extraocular muscles and a need for an assistant to help retract the tissue.…”

Section: Discussionmentioning

confidence: 99%

Peritomy-sparing scleral buckle

Yépez

Murati

Petitto

et al. 2019

American Journal of Ophthalmology Case Reports

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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.

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“…Sutureless buckling is simple, fast, and safe [ Fig. 8 ][ 9 ] In eyes with extensive lattices and retinal tear, one can consider using a broader encerclage (4 mm) along with an explant beneath the retinal tear. The 2.5 mm groove in the explant, meant for the encerclage can be carved using a crescent knife or blade to make it wider to accommodate a 4 mm band.…”

Section: Scleral Bucklingmentioning

confidence: 99%

Novel techniques in scleral buckling

Shanmugam

Ramanjulu

Mishra

et al. 2018

Indian J Ophthalmol

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Scleral buckling is a surgical technique that is employed successfully to treat rhegmatogenous retinal detachments (RRD) for more than 60 years. With the introduction of pars plana vitrectomy (PPV), there is a growing trend towards the use of PPV for treatment of retinal detachment. There is a reluctance to perform scleral buckling (SB) in RRD due to the perceived steep learning curve, declining mastery over indirect ophthalmoscopy, and poor ergonomics associated with SB. In this article, we discuss the surgical challenges and tips to overcome these in four headings: localization of the break, retinopexy, SB, and subretinal fluid (SRF) drainage. Localization of the break can be performed by the use of forceps or illuminated scleral depressor. It can be facilitated by prior drainage of SRF in cases with bullous RRD. Chandelier with wide-angle viewing system can be used for easier localization of break and cryopexy. Sutureless buckling and suprachoroidal buckling are easier and faster alternatives to the conventional technique. Reshaping the silicone segment helps in accommodating the wider circumferential band. Modified needle drainage, laser choroidotomy, and infusion-assisted drainage can make SRF drainage easier and safer. The above techniques and other practical tips have been explained in detail with the illustrations to make the process of learning the art of SB easier.

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Sutureless scleral buckle in the management of rhegmatogenous retinal detachment

Cited by 9 publications

References 9 publications

Heads up Sutureless Chandelier assisted scleral buckle

Heads up Sutureless Chandelier assisted scleral buckle

Peritomy-sparing scleral buckle

Novel techniques in scleral buckling

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