Our experience in minimized surgery for retinal detachment: first results

This study included the first 35 patients with retinal detachment that underwent cryopexy and scleral segmental buckling by silicone sponge with nondrainage and without serclage after Lincoff. Precise localization of the retinal lesions and proper circumferential cryopexy was achieved intraoperatively under the guidance of indirect ophthalmoscope provided with +20/+30d biaspherical lens (Volk, USA). Mean age of the patients was 42 +/- 11 years. A single hole/break was visualized in 20%, two holes/breaks in 26%, and more than two holes/breaks in 40% of the patients; disinsertion of the retina of one quadrant was present in 14%. The duration of the disease was less than 3 months in 66% and more than 3 months in 34% of the patients. On the first postoperative day anatomical reattachment of the retina was achieved in 86% of the patients and in 14% of the resorption was delayed until day 7. Postoperative haemophthalmus, vitreitis, ischaemia of the anterior ocular segment, or elevated intraocular pressure were found in none of the patients. All patients were discharged with reattached retinas. Visual acuity was more than 0.5 in 60% and from 0.1 to 0.5 in 40% of the patients. At the last postoperative examination the visual acuity was 1.0 in 40%, 0.5-0.9 in 40% and 0.1-0.4 in 20% of the eyes. The retina was reattached in all patients. The method of minimized surgery for retinal detachment yields good anatomical and functional results. It helps to avoid the postoperative complications of conventional scleroplastic surgery with serclage and drainage.