Primary Retinal Detachment

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6 Minimal Segmental Buckling With Sponges and Balloons
Fig. 6.2. Optimal orientation of segmental buckle as tamponade of horseshoe
tear. Left: Using a circumferential buckle, the horseshoe tear is not
tamponaded adequately. The operculum, an area of future traction, is not
on the ridge of the buckle, but on the descending slope. In addition, there
is a risk of posterior radial folds (“fishmouthing”) with subsequent leakage
of the tear. Right: A short radial buckle provides an optimal tamponade
for the horseshoe tear. The entire tear is placed on the ridge of the
buckle, i.e., this counteracts posterior “fishmouthing” of the tear and provides
an optimal support for the operculum, counteracting at the same
time future anterior vitreous traction
Fig. 6.3. Limit of an optimal circumferential buckle. When applying a
circumferential buckle, radial folds are less likely if the buckle is not
longer than 90°. If the circumferential buckle is less than 90°, the induced
radial folds, caused by the constriction of the globe, will be just compensated
by the two sloping ends of the buckle