But the first buckling procedure using an exoplant was performed by Custodis in 1949. 1937, Jess was the first one a foreign substance to create a scleral buckle. This in effect caused both shortening and a buckling effect in the manner of encirclage. The sclera was inverted and closed with application of diathermy or later cryotherapy/photocoagulation. This was modified and evolved into lamellar resection of sclera where two-thirds of the outer sclera were removed over the break in a circumferential manner. Mueller introduced shortening of sclera in 1903 to reduce the volume of the globe in the hope that the neurosensory retina and the RPE would appose due to a suction effect. Here we highlight the scleral buckling evolution. The modern techniques can broadly be classified into retinopexy, scleral buckling, and vitreous surgery with intraocular tamponade. Major advances included the use of intraocular air to seal breaks and the scleral resection experiments which later evolved into scleral buckling. The decades following his work usually involved variants of this method, with the success rate of reattachment being around 50%. Gonin originally used a Paquelin thermal cautery to seal the break via vitreous. He was able to show that breaks were in fact the cause of the detachment and successful treatment would require their sealing. It was Gonin who first reported the successful treatment of detachment by sealing the retinal break to the underlying RPE and choroid. The history of retinal detachment surgery can be broadly divided in to the pre (before 1920s) and post–Jules Gonin era (1930s and later). The pathophysiology, primary prevention and clinical features are discussed in detail on EyeWiki page Retinal detachment. Rarer ones include infectious retinitis, and hereditary vitreoretinal disorders. The most common ones are myopia, trauma, posterior capsular rupture during complicated cataract surgery, and retinal degenerations like lattice degeneration. Rhegmatogenous retinal detachment occurs essentially due to the presence of a break associated with vitreous liquefaction, traction and intraocular fluidics combining to overcome the physiological forces which keep the neurosensory retina apposed to the pigment epithelium. 7.2 Complications specific to minimal extraocular surgery using non-drainage approach.7.1 Complications of scleral buckling & cryotherapy.5.2 Orientation of the segmental buckle plan:.
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