How Drainage Works

Although fluid drainage was part of Gonin's ignipuncture technique, it had been performed without attention to retinal breaks and accordingly with predictably poor results. Rosengren, who injected air intravitreally, also drained [23]. Arruga and Schepens both drained subretinal fluid to bring the neuroepithelia into apposition and to make space for the volume reduction that encircling entailed. Drainage also shortened recovery time, which both relieved the unease of the surgeon and shortened hospital stays from weeks and months (Treatment of Samelsohn, [7]).

Schepens reserved bed rest for macula-on retinal detachments. For all other detachments, subretinal fluid was desirable, since it made volume reduction more effective and safer: "In all other cases, the patients are encouraged to be up and about, in order to keep the retina detached prior to surgery, because the scleral buckling operation, which necessarily decreases the volume of the eye, requires the loss of ample subretinal fluid at the time of operation" [2]. The amount of fluid to be removed from the eye was investigated by Thompson and Michels. The volume displacement of a 2.5-mm-wide band was measured to be 0.5 ml; with explants, the displaced volume could be close to 2 ml or up to 45% of the vitreous cavity [24].

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