Primary Retinal Detachment

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10 Retinal Detachment Repair: Outlook for the Future
Fig. 10.5. A well-visualized peripheral retinal tear
when intraocular lenses, retained lens material, and other difficulties
preclude identification of all retinal breaks [2].
Let us now consider the evolution of surgical techniques in the
future. One of the many obstacles to performing minimal buckling
techniques, as well as pneumatic retinopexy and the balloon buckle,
is the difficulty in finding all retinal breaks in certain eyes as
outlined above. New techniques will evolve to allow visualization of
the peripheral retina, which will make break identification more
universally possible.
New imaging techniques, such as ballistic light imaging
(Fig. 10.6), hold the promise of high-resolution trans-scleral optical
images [3]. Ordinarily, it is not possible to view clearly through
a semi-transparent tissue, such as the thin sclera. A degraded image
results due to scattered light. Light passes through the tissue,
but scatter presents the ability to obtain a clear image. Scattered
light is delayed compared with non-scattered light; however, the
amount of delay is extremely small. The ability to fabricate femtosecond
optical filters can theoretically gate out this scattered
light based on time differences. In the future, such ballistic light
imaging promises to be a non-invasive way of examining the vitre-