Selection of type of operation for rhegmatogenous retinal detachment

Primary success in scleral buckling operations may be enhanced by ophthalmoscopically locating all retinal breaks and accurately localizing the posterior margin of the retinal breaks at the time of operation. A scleral buckle created by either an explant or an implant must be large enough to seal the retinal break completely. In 95 per cent of retinal detachments this may be accomplished by using 7 to 7.5 mm wide buckling material in a 10.5 to 11 mm wide scleral bed which creates a buckle extending from the ora serrata to a point 5 mm posterior to the localized posterior margin of the retinal break. Although in selected cases localized scleral buckles may successfully cure a retinal separation, greater initial success will usually be obtained by a buckle which covers the greater portion of the circumferential extent of the retinal detachment.