Channels: Retina | Posted 7/27/2009
Dr. Berrocal manages these RRD cases with a 23-gauge vitrectomy. After removing the vitreous with the Constellation system (Alcon, Fort Worth, TX), perfluorocarbon is injected to flatten the retina. In the second case, she performs a combined scleral buckle-vitrectomy for rhegmatogenous retinal detachment.
In the case wherein an encirclage was used- the 23G sclerotomies seem to be made over bare sclera. In order to maintain some relatively undisturbed conjunctival cover during the 23G sclerotomy entry I routinely make a posterior peritomy (6 mm behind the limbus) for all my combined buckle-23G surgeries. This slight shift in the peritomy helps to retain the advantages of 23G surgery better than making an entry over bare sclera.
After I fill the eye with heavy liquid, I do a fluid/air exchange draining first through the break and then removing all liquid by aspirating over the optic nerve, then I do laser. For an inferior break at 6 i always put an encircling buckle, specially on a phakic eye since its impossible to remove all the vitreous around the break, so either I do a buckle, or a buckle/vit with gas tamponade.Silicone oil doesnt tamponade adequately the inferior retina so i avoid it in these cases if possible.
dr berrocal, Hi! I have 2 questions:
© 2019 Bryn Mawr Communications, LLC. All Rights Reserved
1008 Upper Gulph Rd, Wayne, PA 19087 | (484) 581-1800
post as anonymous