Primary Retinal Detachment

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104 6 Minimal Segmental Buckling With Sponges and Balloons found that there is one break in 50% of detachments, two breaks in 30%, and three or more breaks in 20%. Thus, after a meticulous preoperative and intraoperative search for the break, in about 50%, not more than one break has to be buckled. In addition, in general, multiple breaks are not distributed over the entire retinal circumference of the eye, but tend to be located within the quadrant of the primary break. Optimum segmental buckling aims to fit the various sizes and configurations of retinal breaks. There can be three or four segmental buckles to circumvent a cerclage. The complications of a cerclage tend to be: anterior segment ischemia, hypertension or hypotension, uveitis, decreased retinal and choroidal blood flow and eventual unilateral pigmentary dystrophy, constricted visual field,reduction in two-point discrimination,and diminished retinal activity or a reduced amplitude of the electroretinogram [27–32]. <strong>Detachment</strong>s with multiple breaks and even with proliferative vitreoretinopathy (PVR) grade C1–C2 can be treated with segmental buckling and without drainage (Figs. 6.4–6.8). The segmental buckles may consist of radials, short circumferentials, or a combination of both, but without a cerclage.
Minimal Segmental Buckling With Sponge(s) 105 a b Fig. 6.4. Total detachment in pseudophakic eye. a There is a horseshoe tear at 11:00, a round hole at 12:00, and traction lines (insertion of the vitreous base) in the entire periphery. b After buckling of the two breaks by a short circumferential sponge buckle,the retina had attached without drainage the next morning.After 1 week,the cryopexy lesions had pigmented and subsequently the so-called traction lines disappeared. The retina remained attached during the next 15 years
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Ingrid Kreissig (Ed.) Primary Retin
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Professor Dr. med. Ingrid Kreissig
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Contents 1 The History of Retinal D
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List of Contributors Gary W. Abrams
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List of Contributors XI Hermann D.
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2 Helmholz in 1850 made an accurate
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4 (vitreous, gelatin) into the ante
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6 with scleral resection that set t
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8 ditis [72-74].Temperatures up to
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10 1 The History of Retinal Detachm
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16 ion [147]. Perfluorocarbon liqui
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26 2 Prophylaxis in Fellow Eye of P
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32 found that eyes with pre-existin
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36 3 Encircling Operation with Drai
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Page 62 and 63: 52 3 Encircling Operation with Drai
Page 64 and 65: Chapter 4 Pneumatic Retinopexy for
Page 66 and 67: Technique 57 Case Selection Proper
Page 68 and 69: Technique 59 Table 4.1. Gas charact
Page 70 and 71: Technique 61 solution; however,thes
Page 72 and 73: Technique 63 gas reflux. Following
Page 74 and 75: Complications: Prevention and Manag
Page 76 and 77: New Possibilities 67 ing on type an
Page 78 and 79: Results 69 Table 4.7 (continued) Au
Page 80 and 81: Discussion 71 surgical failures. Fa
Page 82 and 83: Discussion 73 Disadvantages of PR A
Page 84 and 85: References 75 situations, then to p
Page 86 and 87: References 77 24. Tornambe PE, Hilt
Page 88 and 89: References 79 51. Pournaras CJ, Don
Page 90 and 91: Chapter 5 Vitrectomy for the Primar
Page 92 and 93: Indications 83 Table 5.1. Indicatio
Page 94 and 95: Indications 85 Fig. 5.2. The vitreo
Page 96 and 97: Surgical Technique 87 vitrectomy an
Page 98 and 99: Outcomes 89 will be visible under a
Page 100 and 101: Outcomes 91 almost no persistent su
Page 102 and 103: References 93 7. Heimann H, Bornfel
Page 104 and 105: 96 6 Minimal Segmental Buckling Wit
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Page 108 and 109: 100 the operating table with the re
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Page 114 and 115: 106 a b 6 Minimal Segmental Bucklin
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Page 130 and 131: 122 c d 6 Minimal Segmental Bucklin
Page 132 and 133: 124 c Fig. 6.14c 6 Minimal Segmenta
Page 134 and 135: Table 6.1. Preoperative characteris
Page 136 and 137: Table 6.3. Final attachment after m
Page 138 and 139: 130 Choroidals In 4 of the 1,462 de
Page 140 and 141: Table 6.4. Visual acuity at 2 years
Page 148 and 149: 140 Probably, the future question n
Page 154 and 155: 146 7 Pharmacological Approaches to
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154 search for compounds with hepar
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156 7 Pharmacological Approaches to
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158 7 Pharmacological Approaches to
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Chapter 8 Systematic Review of Effi
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Materials and Methods 163 Table 8.2
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Discussion 165 30% 25% 20% 15% 10%
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Discussion 167 Fig. 8.2. The small
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Conclusion 169 vitrectomy and searc
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References 171 8. Brazitikos PD, D
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References 173 34. Gunduz K, Gunalp
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References 175 63. Schepens CL (195
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178 9 Repair of Primary Retinal Det
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180 a b Fig. 9.3a,b. Legend see pag
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186 a b 9 Repair of Primary Retinal
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188 might eliminate traction on the
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Chapter 10 Retinal Detachment Repai
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Retinal Detachment Repair: Outlook
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References 207 It is impossible to
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210 C Campbell 7 case selection 57,
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212 M Machemer 13 macular - complic
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214 retinal - detachment - - bilate
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Primary Retinal Detachment

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