Up Next

Please see a subsequent video. Based on ndmayfield's feedback, I did not use a scleral buckle on the subsequent case and the patient had a very good outcome.

Reply

As far as slippage goes, I always worry about it. First, I try to avoid an overly high buckle. More importantly, during air-fluid exchange I try to spend extra time aspirating fluid above perfluron at the edge of the tear. I think there is a decent amount of BSS adherent to the back of the lens and pars plicata and it slowly drips down and gets under the retina. This creates a plane that allows slippage. The extra time spent aspirating that fluid reduces chance of slippage. I do agree that orthodoxy of what we've been taught can get in the way of better surgery. Always looking forward to anyone else's comments or advice.

Reply

Great technique. Where i practice we have this old school approach of always using oil with giant tears. Lovely demonstration on how to break away from these classic teachings.

Reply

Have you experienced "slippage" of the edge of the giant tear when using a buckle? I have started trying to do these cases without a buckle if at all possible. The edge of the tear seems to slip less when the buckle is absent. It's almost like the edge of the tear "falls down" because of the height of the buckle.

Reply

While there is more than one way to approach this case, in my mind the buckle is a nice adjunct in GRT cases. While I trained with lots of buckle-vit emphasis, I've moved away from using buckles as often.

Reply

I agree that the buckle was unnecessary

Reply

nice vitrectomy why even bother with the buckle?

Reply