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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.

Retinal Cases & Brief Reports

|May 19, 2026

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A new technique using a guarded diamond blade for scleral buckle surgery creates precise grooves, reducing perforation risk. This method enhances surgical safety and efficiency in treating retinal detachment.

Area of Science:

Ophthalmology
Surgical Innovation
Retinal Surgery

Background:

Rhegmatogenous retinal detachment (RRD) requires surgical intervention, often involving scleral buckle (SB) procedures.
Traditional SB surgery involves creating scleral belt loops, which can carry risks of perforation and inconsistent groove formation.

Purpose of the Study:

To introduce and evaluate a novel technique for scleral belt loop formation during SB surgery.
To utilize a guarded diamond limbal relaxing incision (LRI) blade for improved precision and reduced complications.

Main Methods:

A conventional SB procedure for RRD was performed using a #240 encircling band.
Partial-thickness scleral grooves (150 µm depth) were created using a guarded diamond LRI blade in each quadrant.
Operative efficiency, tissue resistance, and groove quality were assessed intraoperatively.

Keywords:

Belt loops Diamond blade Intraoperative OCT Scleral buckle

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Main Results:

The guarded diamond blade facilitated single-pass, uniform groove formation with minimal resistance and excellent visualization.
No intraoperative complications such as scleral perforation, hypotony, or hemorrhage were observed.
Groove creation was rapid and reproducible, indicating high efficiency.

Conclusions:

The guarded diamond LRI blade offers a precise, efficient, and low-risk method for scleral belt loop creation in SB surgery.
This technique presents a valuable alternative to traditional dissection methods, potentially enhancing surgical safety and efficiency.