Are Encircling and Drainage Still Popular Methods

In light of the above tales of both success and morbidity, are encircling and drainage still done? The short answer is that encircling with drainage, as opposed to minimal segmental buckling without drainage [36], requires less-accurate meridional localization of all breaks, is subsequently somewhat easier to do, and works at the short-term risk of hemorrhage and long-term risk of choroidal ischemia.

In more recent (1982-2002) clinical series on scleral buckling [15, 26,37,38], encircling was practiced in 43-100% (average 74%) and was combined with drainage in 72-85% (average 78%) of total cases. Gas was injected in 26-32% in two series; this procedure is also known as "pneumatic buckle" [15,37]. Primary success ranged from 78% to 96% (average 85%). Obstacles to success were aphakia/pseudophakia, whereas the main benefit of encircling relative to alternate procedures was found to be the low incidence of secondary tears (1.3% versus 18-20%) [15].

It is of note that two of the series [15,37] compared scleral buckling (78-100% encircling and 72-85% drainage) to pneumatic retinopexy. Scleral buckling was therefore used synonymously with encircling and drainage in the recent literature and we can assume that it represents the standard of care.

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