|Year : 1983 | Volume
| Issue : 1 | Page : 9-10
Inexpensive scleral explants for detached retina
Oscar G, Cortes B
Deptt. of Ophthalmology, University of San Simon Medical School, Cochabamba (Bolivia),
Cochabamba, Bolivia Clinica Oftalmologica Av. Salamanca N. 0860
|How to cite this article:|
G O, B C. Inexpensive scleral explants for detached retina. Indian J Ophthalmol 1983;31:9-10
In certain areas it is difficult to obtain a regular, sufficient supply of silicone sponges, bands, and bars. This makes it difficult for the surgeon to properly attend to patients with detached retinas.
The purpose of this article is to report the experience of this author in using an inert material, of adequate elasticity, inexpensive, and easy to obtain for scleral explants in retinal surgery.
| Materials and methods|| |
Between April 1, 1976 and October 31, 1981, 37 scleral explants were performed on patients with different types of detached retinas using the border of nipples of baby bottles (The nipples are made by Even fib Products Company, approved by the Food and Drug Administration of the United States of America, as non-toxic and non-allergic). It is impossible to give the chemical composition as it is the propriety of the manufacturer.
The base of the nipple has an external border that is thicker and that can be easily separated with curved surgical scissors, in this way providing a band of 12.5 ems. long, 2mm. wide, and 2.5 mm. thick. [Figure - 1] The materrial obtained should be sterilized by autoclave for 15 minutes at 80 pounds pressure, twice in succession, before being used in surgery. The applications of this material in the surgical technique are similar to those of the silicone sponge, and it can be used in encircling procedures or localized indentation of the sclera. [Figure - 2] The characteristics of elasticity and management are comparable to the traditional explants. Of the 37 patients, eight were detachments of traumatic origin, six detachments were aphakic. 14 were in high myopes, and nine were primary rhegmatogenous detachments for peripheral degeneration. Nineteen surgical procedures, with an encircling element, were preformed. Eighteen scleral isolated explants of indentation were performed.
The locations of the tears were temporoinferior in 17 cases : naso-inferior in I I cases temporo-superior in 5 cases, and naso-superior in 4 cases. In two cases the patients had a giant tear near the posterior pole.
| Observations|| |
All cases, where an encircling element was used, were successful in the correction of the detachment. Three cases, where there was a localized explant, were failures and a second surgery with an encircling element was necessary.
Sixteen isolated explants were performed, placing the element parallel to the corneoscleral limbus and two perpendicular to the limbus.
In all cases surgery was performed under Indirect Ophthalmoscopic control.
Cryopexey was used in surgery on all patients. In 24 cases was there surgical drainage of the sub-retinal fluid. No patient manifested signs of rejection of the implanted material. No postoperative complications or infections were observed. Maximum period of observation was 5 years and 7 months with 1 month as minimum period of observation.
| Discussion|| |
The experience of the author in 37 cases of detached retina, using an easily obtainable, inexpensive, and inert material, proves it to be a useful encircling element or scleral explant.
The number of surgeries performed, the period of observation postoperatively, and the high index of success obtained, permit the recommendation of the use of this material to supplement or replace the traditional elements of silicone used in surgery of the retina.
| Summary|| |
Inexpensive scleral explants for detached retina are described.
[Figure - 1], [Figure - 2]