Primary Retinal Detachment

Retinal Detachment Repair: Outlook for the Future 199
Fig. 10.9. Vitreous endoscopy allows visualization of far anterior structures
such as the ciliary body and pars plana
patients to be treated at earlier stages of the detachment, when the
macula has not been affected, and the rate of success is higher.
High-resolution scans, such as those used now for magnetic resonance
imaging (MRI) scanning of the head and neck vessels, may
become applicable to the retinal periphery and help with break localization
and prophylaxis issues. Functional MRI may increase
our understanding of peripheral retinal tissues as well. This technique
may allow insights into vitreous and peripheral retina metabolism
and degeneration and may help allow us to predict those
at risk for early vitreous detachment and retinal detachment [5].
Intraoperative techniques will evolve, and these will include even
better wide-angle viewing systems and the future use of stereoscopic
endoscopy, which will allow the advantages of stereoscopic
viewing and tissue manipulation currently not possible with grin
and other forms of endoscopy [6] (Fig. 10.9). New lasers may allow
us to transect the flaps of flap tears, thereby relieving traction; if
this is possible, retinopexy may not even be required, and minimal
manipulations to close the break may be possible. Electron knives
and other devices will be able to be used intraoperatively to allow
tissue to be cut in a non-traumatic and, therefore, non-pro-inflammatory
manner.