Surgery: Utilizing a Large Radial Sponge and Scleral Buckle to Repair a Retinal Detachment

This video demonstrates the use of vitrectomy and a large radially oriented sponge in conjunction with a scleral buckle to help repair a retinal detachment.

Surgeon: John W. Kitchens, MD, Retina Associates of Kentucky, USA


Dr. Kitchens: Sometimes you just need a lot of external imbrication just in one area. And this is a great example of a case like this. This is a patient at a PVR-related retinal detachment. And we had put a buckle around this patient’s eye, I believe it was a 41 band. And now we’re inside the eye and we’re going to try to drain him flat. With our external needle drainage, I love using external needle drainage when I’m doing a vitrectomy because you have the infusion and you can turn the infusion up to 80. And you have your light pipe internally. And so that really flattens out this retina nicely.

But one thing that we see as we’re doing our vitrectomy is this star fold. This is a reoperation. And this star fold was right next to a new break. I believe this star fold emanated from the original draining retinotomy which was a posterior draining retinotomy. And I’m trying to just simply pinch in the middle of this star fold and peel the fibrosis off of there. But it’s just not working.

So we end up sliding in a radial sponge underneath our 41 band. And we really don’t even need to suture this sponge, we just slide it under, and trim it, and slide it back. And we get, because of the orbital pressure, and the orbital fat, and where it’s located, we’re able to get this really beautiful, big imbrication with no sutures. And so by sliding it a little bit further over, we’re able to support that star fold, we’re able to drain through that new break. And that external buckle, which you see now as we go to air, the real extent of it, just gives us the perfect amount of support so that we don’t have to do a focal retinectomy in this area. We’re able to just laser nicely around those areas in support, primarily that star fold. Thank you so much for watching.

3D Version

January 26, 2021

Last Updated: October 31, 2022

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