Sutureless encircling band – biomechanical calculations and clinical experience

Abstract

Purpose In cases with multiple retinal breaks and in combination with vitrectomy in eyes with Proliferative vitreoretinopathy (PVR) for retinal detachment surgery often an encircling band is used. Usually the encircling band is fixed with non absorbable sutures. Methods A fixation method for an encircling band in retinal detachment surgery with one scleral tunnel in every of the 4 quadrants is reported. We describe our experience and biomechanical calculations of this fixation technique. Results In comparison to conventional fixation technique we found the following advantages: No suture is necessary, this means no additional foreign body can produce irritations. The scleral tunnel is safe and the preparation under the microscope can be performed fast and well controlled. Sclera tunnel fixation is very comfortable in combination with a vitrectomy. Conclusion With a short learning curve the operating time is as short as with conventional suture fixation of the encircling band. There is less perforating risc, less irritation and less patient discomfort postoperatively. A sutureless encircling band with sclera tunnel fixation is a very usefull operation technique in clinical routine.

Refractive outcomes following silicone oil tamponade in vitreoretinal surgery

“…Belt buckling leads to elongation of the optical axis, which in turn creates myopic shift and reduces tractional forces to ensure refraction with SOT. [ 4 6 ] A higher-viscosity SO has been reported to have a lower tendency to emulsify. [ 8 ] Moreover, the SO causes a change in refraction around 6D.…”

“…As SO does have a higher refractive index (1.405) than the vitreous humor (1.336), it causes a substantial variation in refraction when it is introduced into the vitreous cavity. [ 3 4 ]…”

Nahtlose Cerclage mit Skleratunnelfixation

“…Refraktive Veränderungen sind unmittelbar auf den einschnürenden Effekt zurückzuführen. Das Ausmaß der Myopisierung ist von der Spannung und damit dem eindellenden Effekt der Cerlage abhängig [6,14]. Die myopisierende Wirkung ist bei gleicher Cerclagespannung allerdings bei der Skleratunnelfixation geringer [6,13].…”

“…Das Ausmaß der Myopisierung ist von der Spannung und damit dem eindellenden Effekt der Cerlage abhängig [6,14]. Die myopisierende Wirkung ist bei gleicher Cerclagespannung allerdings bei der Skleratunnelfixation geringer [6,13]. Postoperativ kann es zur Erosion oder Intrusion des Cerclageelements kommen [7,10,14].…”

Use of an injectable, 25‐gauge shape‐memory clip to fixate an encircling silicone band: a laboratory model

“…Buckling elements are typically affixed to the sclera using nonabsorbable suture material such as mersilene, prolene or nylon. Other authors have demonstrated alternate means of hardware fixation including sclera tunnels and glue (Ricci & Ricci 2001 and Maier et al. 2011).…”