Scleral damage: comparison of standard and modified diathermy electrodes

Scleral electrocautery and its effects on choroid vessels: implications for subretinal fluid drainage during scleral buckling surgery

BACKGROUND AND OBJECTIVE

External drainage of subretinal fluid as part of a scleral buckling procedure rapidly restores the retinal pigment epithelium-neural retina interface in rhegmatogenous retinal detachments but carries the inherent risk of subretinal hemorrhage and retinal incarceration. The authors investigated variations to the technique to reduce the chance of subretinal hemorrhage originating from the choroid.

MATERIALS AND METHODS

A novel method for needle drainage using electrocautery of the sclerochoroidal layers before puncture was employed. The effect of 0% to 50% scleral electrocautery in a porcine model was investigated.

RESULTS

A significant decrease in choroidal vessel diameter and choroidal vessel density at 40% electrocautery was demonstrated.

CONCLUSION

Electrocautery without scleral cut-down before external drainage of subretinal fluid likely decreases the chance of subretinal hemorrhage by decreasing choroidal vascularity.

Scleral buckle removal: indications and outcomes

Primary scleral buckling has been an effective means to reattach the retina for over 50 years. After surgery, complications may arise that require scleral buckle (SB) removal. The most common indications for SB removal are extrusion, infection, and pain. I review the pertinent literature in an effort to develop guidelines for when to remove a SB.