Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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Are Encircling and Drainage Still Worth Doing? 47<br />
Fig. 3.7. A detachment with a good prognosis. A one-quadrant detachment,<br />
one break, in a 50-year-old male patient, flattened with bed rest.<br />
A radial 5-mm sponge was placed, followed by laser<br />
phakic status (Fig. 3.7). Indicators of poor prognosis include: many<br />
breaks, undetectable breaks, a large area of detachment, bullous detachment,<br />
aphakic/pseudophakic status and proliferations of vitreous<br />
and retina (Fig. 3.8). Not surprisingly, these indicators are similar<br />
in the literature on both buckling and pneumatic retinopexy [16].<br />
Minimal procedures are appropriate to repair more favorable<br />
cases, whereas procedures associated with higher morbidity are reserved<br />
for the complex case. Schepens corroborated this finding.<br />
“The circling element was at first used in cases with an unfavorable<br />
prognosis.As experience with this procedure increased it was used<br />
on more and more favorable cases and it was found to be the most<br />
dependable operation”[2]. This misconception, that if it is good for<br />
complicated cases it is even better for uncomplicated ones, has<br />
proved to be a common reasoning in clinical practice, as observed<br />
by Lincoff and Kreissig [41].