Primary Retinal Detachment

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6 Minimal Segmental Buckling With Sponges and Balloons
3. An old detachment with a pigment demarcation line and an
intraretinal cyst (Fig. 6.12); here too, a balloon buckle sufficed.
4. The balloon can also be used as a diagnostic tool to test for
presence of only one break in two separate detachments
(Fig. 6.13).
5. Or, the balloon can be used even in a detachment up for reoperation
with PVR stage C2 (Fig. 6.14).
Why Is the Balloon Operation so Difficult to Accept?
The premises for success are: (1) a maximum of preoperative diagnostics,
so as not to overlook a break; (2) a precise localization
of the break at the table without prior drainage; (3) marking the
detached break on mobile conjunctiva (in contrast to the segmental
sponge operation, in which the break can be marked precisely
on the sclera); and (4) localization of a highly elevated break on a
yet slightly indenting parabulbar balloon in presence of a bullous
detachment with a pronounced and misleading parallax.
Advantages of the Balloon Operation
Advantages of the balloon operation are as follows:
1. The surgery is short, ranging between 10 min and 20 min
2. The anesthesia is topical or subconjunctival
3. The recovery of vision is fast and optimal
4. The last complications of segmental buckling are eliminated,
i.e., there is no buckle infection, because the balloon is removed,
and no diplopia. Diplopia, if present, disappears after the balloon
is withdrawn.