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Drainage of subretinal fluid in retinal detachment surgery with the El-Mofty insulated diathermy electrode
B R Saran1, A J Brucker, A M Maguire
1Retina Service, Scheie Eye Institute, Philadelphia, PA 19104.
Purpose:
A technique that uses the El-Mofty/Schepens diathermy tip (MIRA, Inc.) to effect drainage of subretinal fluid during scleral buckling surgery is described. The efficacy of this drainage technique and its complication rate in a series of consecutive patients is discussed.
Methods:
The study included all of the scleral buckling procedures performed at the Retina Service for retinal detachments in which this technique was used. The El-Mofty/Schepens diathermy tip was first used to cauterize the choroid at the drainage site at low power, thus rendering it avascular, and then at higher power, to cause vaporization of the choroid, and allow spontaneous drainage of subretinal fluid. The success rate and all intraoperative and postoperative complications were recorded.
Results:
This technique achieved successful spontaneous drainage in 53 (82.8%) of 64 consecutive cases. Complications that are occasionally associated with the drainage of subretinal fluid, including iatrogenic retinal holes, choroidal hemorrhage, and retinal incarceration in the sclerotomy site, were not seen in any of the cases.
Conclusion:
This method provides a simple and safe technique for the drainage of subretinal fluid that obviates the need to directly perforate the choroid.
Insights
A new diathermy technique safely drains subretinal fluid during scleral buckling surgery, achieving an 82.8% success rate without complications. This method avoids direct choroidal perforation for retinal detachment repair.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Retinal Detachment
Background:
- Subretinal fluid drainage is crucial in scleral buckling for retinal detachment.
- Traditional methods carry risks of complications like retinal holes or hemorrhage.
Purpose of the Study:
- To describe and evaluate a novel diathermy technique for subretinal fluid drainage.
- To assess the efficacy and complication rate of this technique in scleral buckling surgery.
Main Methods:
- Utilized the El-Mofty/Schepens diathermy tip for subretinal fluid drainage.
- Employed low-power cauterization followed by high-power vaporization of the choroid at the drainage site.
- Consecutive cases of retinal detachment treated with scleral buckling were included.
Main Results:
- Successful spontaneous drainage was achieved in 82.8% (53/64) of cases.
- No intraoperative or postoperative complications, such as iatrogenic retinal holes or hemorrhage, were observed.
- The technique effectively facilitated subretinal fluid drainage without direct choroidal perforation.
Conclusions:
- The El-Mofty/Schepens diathermy tip offers a simple and safe method for subretinal fluid drainage.
- This technique obviates the need for direct choroidal perforation, reducing associated risks.
- It presents a valuable alternative for managing subretinal fluid in scleral buckling procedures.