View 1: Minimal segmental buckling without drainage

Scleral buckling involves either an encircling buckle, called cerclage, extending over the entire periphery of the retina with drainage of subretinal fluid or, as refinement, a segmental buckle (elastic sponge) extending over the area of the retinal break(s) and performed without drainage. The latter surgery is called “minimal segmental buckling” (MSB) and represents an extraocular technique for the repair of rhegmatogenous retinal detachments.1 The elasticity of the sponge buckle makes it possible to eliminate drainage of subretinal fluid. The buckle and coagulation therapy, either cryopexy or laser, are limited to the area of the break(s). Consequently, it is of utmost importance to identify the break(s) and to position the buckle in the correct location. A further refinement of MSB is the balloon procedure, in which the segmental buckle is a temporary balloon which is not sutured onto the sclera and is withdrawn after a week. A Medline search identified 1462 primary retinal detachments treated with MSB without drainage. The buckle consisted of either segmental sponges (n = 962 detachments)1–6 or a temporary balloon (n = 500 detachments)7 with coagulation therapy limited to the area of the break(s). The procedure is undertaken under local or topical anaesthesia with inexpensive equipment and few trained additional personnel are required. It can be performed in an outpatient setting and on …