Program list

SYMPOSIUM: WEAPONS CHOICES
SECTION: Retinotomies and Retinectomies
Moderators: Claudio Azzolini, Suvad Karcic
Monday, September 15th, 2003 ; 11:00 - 13:00

BUCKLING WITH SCLERAL SHORTENING REPLACING RETINOTOMIES
Didier Ducournau, MD
Nantes, France

Folds of full thickness reduce the retinal surface which becomes then smaller than the RPE's one. Despite dissection, some degrees of retractions can persist (because of intraretinal glyosis). We can then continue the section with the risk of creating the iatrogenic tears or carry on retinotomy and silicon oil injection. A third solution is to perform an indentation plus folds. The indentation will relax the vitreous base and support the peripheral tears. The additional shortening of the sclera will compensate the difference on surface between retina and RPE. In order to perform an indentation-folds, we must:
- use an uncompressible buckling material (a sponge will deform and impede the scleral shortening.
- place double U sutures with intra scleral pathways perpendicular to the explant. The posterior radial pathway must be longer than 2mm.
During the tightening of the sutures the sclera will deform against the incompressible material and this will reduce the RPE surface. No need then to take the risk of a hardline dissection or a silicone oil injection.