Safar's Method for Treatment of Detachment of the Retina by Diathermy

Safar's method aims at getting discrete areas of coagulation in the choroid without any injury to the retina. Larson produces areas of coagulation by surface cauterization with a small, ball-shaped electrode. Weve uses Larson's method, and also the encircling method with a fine needle.The advantages of Safar's method are: (a) The exact placing of the area of coagulation; (b) the possibility of using a more regular current; (c) less likelihood of the area of coagulation being too extensive; (d) the possibility of making large barrages without losing fluid and the eye becoming soft; (e) the avoidance of having to make a subsequent puncture to draw off the subretinal fluid.Technique.-(1) Nearly the same as Guist's encircling method or the formation of barrages. (2) INSTRUMENTS: Special isolated needles to avoid sparking and also to limit the depth of entry. Special ivory-headed retractors; glass retractors are also useful.Treatment.-(1) Previous to operation: rest in bed, with the use of Lindner's Lochbrille. (2) Subsequent to operation: eight to fourteen days with both eyes bandaged. Wearing of the Lochbrille after the bandages have been removed.Scars.-Ideal scars about the size of optic disc, round, and stippled with small spots of pigment; the retina lies flat over these scars as seen by tracing the retinal vessels.Results. Up to 1932 (Safar's).-Thirty-nine unselected cases: twenty-four reattachments, that is, more than 60% in recent cases of myopia, and after contusion more than 90%.