Modified Controlled Encircling Scleral Buckle for Retinal Detachment

Abstract

During encircling scleral buckle placement, the ends of the element are tightened to achieve a shortened radius of the eye. The determining factor of the final buckle height is subjective using usually a combination of the buckle height visualized with the degree of scleral indentation and can be difficult to be taught early on to trainees. Here, we describe a case series in which a modified controlled encircling scleral buckle technique that simplifies and standardizes the achievement of reproducible buckle height of about a 1 mm is objective and easy to be taught. This novel encircling scleral buckling technique successfully achieves a good postoperative scleral buckle height in a reproducible and standardized fashion using objective measurements and it is easier to be taught to trainees.

Encircling scleral buckling for the treatment of retinal detachment: Development in indication and outcome within the last decade

“…[8][9][10][11][12] Young surgeons often shy away from ESB-surgery, as it demands experience to perform it correctly. 20,21 Regarding the demographic characteristics, approximately two thirds of patients undergoing ESB or SBV surgery in our study were male. This male dominance in patients undergoing surgery for RRD has previously been described.…”

“…9 ESBs provide support in areas of vitreoretinal traction away from the RD. 20 Intra-and postoperative complications seem to happen at a comparable rate, although they are more diverse with PPV than with ESB. 14,15 Ultimately it is the surgeons' choice which method is most suitable to perform.…”

Encircling scleral buckling for the treatment of retinal detachment: Development in indication and outcome within the last decade

“…[8][9][10][11][12] Young surgeons often shy away from ESB-surgery, as it demands experience to perform it correctly. 20,21 Regarding the demographic characteristics, approximately two thirds of patients undergoing ESB or SBV surgery in our study were male. This male dominance in patients undergoing surgery for RRD has previously been described.…”

“…9 ESBs provide support in areas of vitreoretinal traction away from the RD. 20 Intra-and postoperative complications seem to happen at a comparable rate, although they are more diverse with PPV than with ESB. 14,15 Ultimately it is the surgeons' choice which method is most suitable to perform.…”

Standardized scleral buckling approach in the management of noncomplex primary rhegmatogenous retinal detachment

“…12,15-17 A rather similar approach with encouraging results was illustrated by Skondra et al who analyzed a small series of 14 patients who underwent RRD repair with a circumferential 5 × 1 mm solid silicone band. 18 In this study, the chandelier light was preferred to indirect ophthalmoscopy, as it may help to acquire a direct, wide, and clearer view during surgery. Several reports have highlighted the advantage of such technique, which may lower the risk of missing the retinal breaks during intraoperative examination.…”

“…Several reports have highlighted the advantage of such technique, which may lower the risk of missing the retinal breaks during intraoperative examination. 18,19 This is crucial in to obtain good postoperative results, as the precise detection of retinal breaks is perhaps the most important skill required in SB surgery. 19,20 Over the years, few reports have compared the efficacy of different SB approaches in RRD treatment, and found no significant differences between segmental, radial or circumferential buckling in terms of postoperative anatomical and functional results.…”

Modified Encircling Scleral Buckle Technique Without Subretinal Fluid Drainage or Retinopexy

“…Unlike the 2πR (or “Vavvas”) buckle, the technique described herein does not use a tire circumferentially around the eye, nor does it utilize cryotherapy (with indirect ophthalmoscopy). Additionally, buckle tightening is based on tactile intraocular pressure as described above rather than using a uniform amount of buckle trimming [ 20 ].…”

Encircling scleral buckling for the treatment of retinal detachment: Development in indication and outcome within the last decade

“…[8][9][10][11][12] Young surgeons often shy away from ESB-surgery, as it demands experience to perform it correctly. 20,21 Regarding the demographic characteristics, approximately two thirds of patients undergoing ESB or SBV surgery in our study were male. This male dominance in patients undergoing surgery for RRD has previously been described.…”

“…9 ESBs provide support in areas of vitreoretinal traction away from the RD. 20 Intra-and postoperative complications seem to happen at a comparable rate, although they are more diverse with PPV than with ESB. 14,15 Ultimately it is the surgeons' choice which method is most suitable to perform.…”

Standardized scleral buckling approach in the management of noncomplex primary rhegmatogenous retinal detachment

“…12,15-17 A rather similar approach with encouraging results was illustrated by Skondra et al who analyzed a small series of 14 patients who underwent RRD repair with a circumferential 5 × 1 mm solid silicone band. 18 In this study, the chandelier light was preferred to indirect ophthalmoscopy, as it may help to acquire a direct, wide, and clearer view during surgery. Several reports have highlighted the advantage of such technique, which may lower the risk of missing the retinal breaks during intraoperative examination.…”

“…Several reports have highlighted the advantage of such technique, which may lower the risk of missing the retinal breaks during intraoperative examination. 18,19 This is crucial in to obtain good postoperative results, as the precise detection of retinal breaks is perhaps the most important skill required in SB surgery. 19,20 Over the years, few reports have compared the efficacy of different SB approaches in RRD treatment, and found no significant differences between segmental, radial or circumferential buckling in terms of postoperative anatomical and functional results.…”

Modified Encircling Scleral Buckle Technique Without Subretinal Fluid Drainage or Retinopexy

“…Unlike the 2πR (or “Vavvas”) buckle, the technique described herein does not use a tire circumferentially around the eye, nor does it utilize cryotherapy (with indirect ophthalmoscopy). Additionally, buckle tightening is based on tactile intraocular pressure as described above rather than using a uniform amount of buckle trimming [ 20 ].…”

Encircling scleral buckling for the treatment of retinal detachment: Development in indication and outcome within the last decade

“…[8][9][10][11][12] Young surgeons often shy away from ESB-surgery, as it demands experience to perform it correctly. 20,21 Regarding the demographic characteristics, approximately two thirds of patients undergoing ESB or SBV surgery in our study were male. This male dominance in patients undergoing surgery for RRD has previously been described.…”

“…9 ESBs provide support in areas of vitreoretinal traction away from the RD. 20 Intra-and postoperative complications seem to happen at a comparable rate, although they are more diverse with PPV than with ESB. 14,15 Ultimately it is the surgeons' choice which method is most suitable to perform.…”

Standardized scleral buckling approach in the management of noncomplex primary rhegmatogenous retinal detachment

“…12,15-17 A rather similar approach with encouraging results was illustrated by Skondra et al who analyzed a small series of 14 patients who underwent RRD repair with a circumferential 5 × 1 mm solid silicone band. 18 In this study, the chandelier light was preferred to indirect ophthalmoscopy, as it may help to acquire a direct, wide, and clearer view during surgery. Several reports have highlighted the advantage of such technique, which may lower the risk of missing the retinal breaks during intraoperative examination.…”

“…Several reports have highlighted the advantage of such technique, which may lower the risk of missing the retinal breaks during intraoperative examination. 18,19 This is crucial in to obtain good postoperative results, as the precise detection of retinal breaks is perhaps the most important skill required in SB surgery. 19,20 Over the years, few reports have compared the efficacy of different SB approaches in RRD treatment, and found no significant differences between segmental, radial or circumferential buckling in terms of postoperative anatomical and functional results.…”

Modified Encircling Scleral Buckle Technique Without Subretinal Fluid Drainage or Retinopexy

“…Unlike the 2πR (or “Vavvas”) buckle, the technique described herein does not use a tire circumferentially around the eye, nor does it utilize cryotherapy (with indirect ophthalmoscopy). Additionally, buckle tightening is based on tactile intraocular pressure as described above rather than using a uniform amount of buckle trimming [ 20 ].…”