OPHTHALMIC OPERATIONS 7 Retinal detachment

Retinal Detachment

Objective

In cases of detachment of the retina from the choroid. The detachment is corrected:

•   By cryotherapy

•   By indenting sclera

•   By encircling the sclera.

Position

Supine.

Anesthesia

Local, retrobulbar and facial nerve injection.

Procedure

1.  It may be necessary to divide a rectus muscle to gain access to a retinal break.

2.  By indirect ophthalmoscope the operator visualizes the site of the retinal break.

3.  A cryoprobe is applied until the tissues around the retinal break are treated.

4.  Explant is fixed to the sclera over the site of the retinal break.

5.  To create an indent and achieve mechanical block of retinal breaks.

6.  A silicone strap is passed under the four recti muscles.

7.  The strap is overlapped and secured in the silicone sleeve. Usually done with cryotherapy.

Instruments

•   General ophthalmoplasty set

•   Retinal set

•   Eye speculae (Clark and Lang), 2

•   Fine artery forceps, curved on flat, mosquito, 10

•   Fine dissecting forceps, 2/3 teeth, fixation (St. Martins)

•   Fine dissecting forceps, 1/2 teeth, fixation (Jayles), 2

•   Fine dissecting forceps, non-toothed, fixation (Moorfields), 2

•   Fine scissors, straight, blunt points (Strabismus)

•   Iris scissors, straight, sharp points

•   Bulldog clips, 4

•   Towel clips (Backhaus), 4

•   Cryotherapy, retinal cryoprobe

•   Gass indentor, appropriate explant

•   Fine pen and methylene blue (Optional)

•   4 (1) and 2 (4/0) Synthetic nonabsorbable or black silk on small half-circle round bodied needle for traction sutures

•   1.5 (5/0) Synthetic nonabsorbable on small curved cutting needle

•   0.5 (8/0) Synthetic nonabsorbable or silk on small cutting needle for conjunctiva

•   0.7 (6/0) Synthetic nonabsorbable or silk on small curved cutting needle for marker suture.

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