Advantages of Primary Minimal Segmental Buckling Without Drainage

Advantages of primary minimal segmental buckling without drainage are as follows:

1. The procedure is extraocular.

2. It is performed under local or topical anesthesia.

3. It can be done in an outpatient setting.

4. It can be performed on a low budget, because it uses less operating time (rarely more than 45 min and 10-20 min with the balloon), inexpensive equipment, and few trained personnel in attendance. For the surgery itself, no costly disposable instruments or expensive intraocular tamponades are required.

5. It can be applied for superior and inferior breaks.

6. There are, except for a rare choroidal in 0.3%, no intraocular complications, such as: secondary glaucoma, cataract, intraocular hemorrhage, intraocular infection, incarceration of retina or vitreous, or iatrogenic tears, because the procedure is extra-ocular.

7. No postoperative head positioning of the patient is required during the day or at night while asleep, and traveling by airplane is not restricted because intraocular gas is not injected.

8. The primary attachment rate of 1,462 primary retinal detachments treated with minimal segmental buckling and without drainage is 91% and after reoperation 97.4% over 2-year follow-up.

9. The low rate of redetachment: over a 2-year follow-up the rate of redetachment in the 1,462 eyes treated with minimal segmental buckling averages 0.6% per year (series 1 to 5) and over a follow-up between 2 years and 15 years (series 2) 0.5% per year.

10. The recovery of visual acuity is optimal after minimal segmental buckling without drainage. In the series of 107 detachments with a mean preoperative visual acuity of 0.3, the mean value at 1 year is 0.6 and 0.5 at 15 years. The observed slight decrease over years is an effect of aging and not of secondary complications.

11. This low rate of intraoperative and postoperative complications, combined with optimal long-term visual results, is of benefit to the elderly patient and to the decreasing financial resources. This becomes more relevant because new treatments for various macular and retinal diseases are increasingly available, however, at very high costs.

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