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Minimizing Risk in Scleral Buckle Surgery: A Novel Approach to Belt Loop Creation Using a Guarded Diamond Blade
Joaquin Sosa-Lockward1, David W Borden, Catherin I Negron
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Purpose:
To describe a novel technique for scleral belt loop formation during scleral buckle (SB) surgery using a guarded diamond limbal relaxing incision (LRI) blade to minimize the risk of scleral perforation and improve groove consistency.
Methods:
A conventional scleral buckle procedure was performed for rhegmatogenous retinal detachment (RRD) with the placement of a #240 encircling band. Four partial-thickness scleral grooves were created in each quadrant using a guarded diamond LRI blade with a preset depth of 150 µm. The band was passed through the resulting belt loops and secured with a Watzke sleeve. Operative efficiency, tissue resistance, and groove quality were assessed intraoperatively.
Results:
The guarded diamond blade enabled single-pass formation of uniform scleral grooves with minimal resistance and excellent visualization. No intraoperative complications were observed, including scleral perforation, hypotony, or hemorrhage. Groove creation was rapid and reproducible.
Conclusion:
Use of a guarded diamond LRI blade for scleral belt loop creation provides a precise, efficient, and low-risk alternative to traditional dissection techniques. This approach may improve surgical safety and efficiency.
