[Detachment surgery without drainage (author's transl)]. 1978

I Kreissig

Detachment surgery without drainage was introduced in 1953 by Custodis and modified by Lincoff. In this method the retinal hole determines the surgical procedure. Subretinal fluid will disappear by fixating an explant the sclera under tension in the area of the hole. The size of the explant depends upon the size of the retinal hole. Radial orientation of the buckle proves to be an optimal tamponade for a horseshoe tear. The change from traditional extensive circumferential buckles and cerclages to radial orientation of the buckle in the area of the hole is to be considered as a logical evolution in detachment surgery. From 1970--1977 there were treated 1000 consecutive detachments with cryopexy and elastic episcleral sponges. Non drainage was done in 93% of the time. The extension of the detachments ranged in 84% of the time from over 1 to 4 quadrants. The surgical procedure, however, consisted in 96% of the cases in segmental buckles with a preference for radial orientation. Cerclage was found to be useful in 4% of the time; an aphakic detachment was no longer an indication per se for an encircling procedure. Reattachment occured in 83% of the cases after one operation and in an additional 8% after reoperation. The complications with this procedure were minor, extraocular and reversibel. In 2,7% of the time an infection was observed around the explant. After removal of the buckles infection disappeared in every eye, re-detachment did occur in none of the eyes.

UI MeSH Term Description Entries
D008722 Methods A series of steps taken in order to conduct research. Techniques,Methodological Studies,Methodological Study,Procedures,Studies, Methodological,Study, Methodological,Method,Procedure,Technique
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011677 Punctures Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures. Micropunctures,Micropuncture,Puncture
D012163 Retinal Detachment Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). Retinal Pigment Epithelial Detachment,Detachment, Retinal,Detachments, Retinal,Retinal Detachments
D003452 Cryosurgery The use of freezing as a special surgical technique to destroy or excise tissue. Cryoablation,Cryoablations,Cryosurgeries
D004322 Drainage The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012590 Sclera The white, opaque, fibrous, outer tunic of the eyeball, covering it entirely excepting the segment covered anteriorly by the cornea. It is essentially avascular but contains apertures for vessels, lymphatics, and nerves. It receives the tendons of insertion of the extraocular muscles and at the corneoscleral junction contains the CANAL OF SCHLEMM. (From Cline et al., Dictionary of Visual Science, 4th ed) Scleral Spur,Scleral Spurs,Scleras

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