[10 years' experience with balloon procedures: skepticism at the beginning, further development of the method,...

The author discusses four fundamental aspects of the balloon procedure in which it contradicts conventional detachment surgery, but which are preconditions for accepting this procedure: (1) the balloon is unsecured by sutures, (2) disappearance of subretinal fluid is induced by a balloon being compressed in the parabulbar space, (3) the balloon implies a temporary tamponade of the break and (4) after the first week the break is secured only by thermally induced adhesions. New instruments for the balloon procedure are introduced: the balloon forceps, the Kombideller (a special indentor), and the Lincoff-Kreissig balloon, which is supplemented by a removable stylette and markings on the catheter. The guidelines for the balloon surgeon are described in detail and summarized in six rules.