On the influence of an equatorial cerclage on closure of posterior retinal detachment

Abstract

A mechanics-based mathematical model of an eye possessing a posterior retinal detachment is presented for the case where an encircling scleral buckle (a cerclage) is sutured around the equator of the eye. The mechanical behaviour of the retina and the globe, both before and after applying the cerclage, is studied. An energy formulation yields the self-consistent equations of equilibrium and boundary conditions of the ocular system, and analytical solutions are established for the scleral buckle, for the globe and for the detached segment of the retina. Results of numerical simulations based on the solutions unveil characteristic behaviour of the ocular system, and demonstrate the influence of the scleral buckle, as well as of the pressure difference between the vitreous cavity and the subretinal space, on the deformation of the eye and on closing the region of retinal detachment. The results indicate that a scleral buckle encircling the equator, normally used for closing retinal tears and associated retinal detachments in the immediate vicinity of the buckle, can have a marked influence on bringing the detached segment of neurosensory retina back into contact with the retinal pigment epithelium, even for detachments at the posterior of the eye.

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

“…The influence of a cerclage over posterior retinal detachments have been investigated with experimental mechanical models by Ge et al, who recently demonstrated that equatorial buckling has a marked influence on neurosensory reattachment posterior to the equator, in accordance with our findings. 26 The SB standardized approach hereby discussed implies the execution of a pneumatic retinopexy plus SRF drainage in almost all cases, except for shallow RRDs in which air injection may be avoided. SRF drainage allows the retina to flatten before the scleral fixation of the buckle.…”