Radial buckling in the repair of retinal detachment

Experience with external sponge buckles for the treatment of retinal detachment has led to a preference for radial placement of the sponge. More retinal holes, particularly large horseshoe breaks, can be closed effectively with radially oriented buckles than with limbus parallel ones; limbus parallel buckles often were complicated by "fish-mouthing" of the breaks and leaking radial folds. A radial orientation of the buckle averts this complication. The geometry of retinal detachment and scleral buckling reveals the origin of "fish-mouthing" and radial folds and why radially oriented buckles prevent this complication.