External buckling without drainage for selected detachments in aphakic eyes.
Of 325 patients with retinal detachments, 110 patients (34%) had aphakic eyes. These detachments were subdivided into three types based on their clinical appearance during indirect ophthalmoscopy and slit-lamp biomicroscopy. Fifty-two patients (47%) had aphakic detachments (Type 3), categorized by small tears due to traction along a prominent posterior or vitreous base and the absence of visible retinal degeneration. Fifty of the 52 patients in this group were operated on by using a modification of the nondrainage procedure developed by Custodis, and employing cryosurgical coagulation and an external encircling buckle using a 3-mm silicone sponge. The sponge was secured beneath the retinal tear, and its length was shortened to produce a moderately elevated buckle. Although 50% of retinal tears were open at the end of the operation, 60% of all eyes operated on without drainage reattached in 16 hours, 90% in one week, and the remainder in two weeks. Visual acuity of 70% of these patients was 6/15 (20/50) or better when tested six months after surgery. The operation did not wall away peripheral fluid, but closed retinal tears completely, reduced circumferential vitreous traction, and avoided drainage of subretinal fluid.
D000368:Aged; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000601:surgery; D012591:Scleral Buckling / Q000379:methods*; D012828:Silicones
D012828:Silicones