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Rhegmatogenous Retinal Detachments Scleral Buckling Procedures without Sub-Retinal Fluid Drainage Dr. Anand Sudhalkar, Baroda.

Rhegmatogenous retinal detachments

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Page 1: Rhegmatogenous retinal detachments

Rhegmatogenous Retinal Detachments

Scleral Buckling Procedures without Sub-Retinal Fluid

Drainage

Dr. Anand Sudhalkar, Baroda.

Page 2: Rhegmatogenous retinal detachments

1st Case : History

• Female 27 yrs,

• Sudden loss of vision OS, 2 days

• PL only

Page 3: Rhegmatogenous retinal detachments

1st Case : Clinical Findings

High Myope (-17D) BE, Total RD LE, Two large HST, Two Lattice, Round Hole

Page 4: Rhegmatogenous retinal detachments

1st case : 2 Radial and 1 Segmental Buckle No SRF Drainage Schiotz tonometry Paracentesis, mannitol, diamox

Page 5: Rhegmatogenous retinal detachments

2 HSTs After Radial BucklesSRF absorbed after 15 days

Page 6: Rhegmatogenous retinal detachments

1st case : after 2monthsRedetachment, buckle revision

The SRf collected 6 to 10 o’clk, pointing to the Location of slipped hole.

Page 7: Rhegmatogenous retinal detachments

After Segmental Buckle revision

•The segmental buckle shifted posteriorlyTo cover the hole at 9.30 O’clk• SRF reabsorbed in 24 hours.

Page 8: Rhegmatogenous retinal detachments

1st Case : After 11 monthsMyopic changes at macula,Vision : FC 10 feet

Page 9: Rhegmatogenous retinal detachments

3rd Case : History

• 65 Yr old Female,

• IDDM 17 years

• Some dimness LE in Oct 03, consultation elsewhere

• Diagnosed as DR and advised better control.

• Severe loss in Jan 04. Diag. PDR Gliosis

• Ref. to us for PDR laser treatment by her Physician In April 2004

Page 10: Rhegmatogenous retinal detachments

3rd Case : History

• Vision : FC lowerhalf.

• Inferior RD

Page 11: Rhegmatogenous retinal detachments

3rd Case : Clinical FindingsRE 6/18 cortical cat. BDR, Attached retina, Tear at 7 O’clkLE FC lower field, cortical cat. BDR, Inf. RD HST at 5.30

Page 12: Rhegmatogenous retinal detachments

3rd case after inferior single radial sponge + Cryo

SRF reabsorbed after 6 days

Page 13: Rhegmatogenous retinal detachments

3rd case after 8 months : Attached retina

LE Vision with cataract, Diabetic maculopathy, FC 15’

Page 14: Rhegmatogenous retinal detachments

Case 2

• 19 Yr Female moderate Myope

• Sudden loss of vision RE noticed accidentally

• RE Counting fingers at 1’ temporally.

• LE 6/9 with -4.0Dsph.

Page 15: Rhegmatogenous retinal detachments

Case 2 Retinal drawings

RE LE

Page 16: Rhegmatogenous retinal detachments

Case 2

Large tearEverted edgeVitreous attachment

Extensive Lattice with holes

Page 17: Rhegmatogenous retinal detachments

Case 2 Surgery details

•Cryopexy surrounding large hole and lattices•Segmental 5 mm sponge 5.30 to 12.30 clock•No SRF Drainage

Page 18: Rhegmatogenous retinal detachments

Case 2 Post buckle follow up

Page 19: Rhegmatogenous retinal detachments

Case 2 The other eye prophylaxis

Page 20: Rhegmatogenous retinal detachments

Case 4

• Male Age: 60 years

• Pseudophakia RE 2 years

• Dimness 4 days

• Vision : Lower temp FC 1’

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Case 4

Page 22: Rhegmatogenous retinal detachments

Case 4 After 1st buckle

SRF absorbed in 3 daysMacula on

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Case 4 : After 15days

• SRF reappears

Page 24: Rhegmatogenous retinal detachments

Case 4 : After segmental buckle

SRF reabsorbed in 2 days

Page 25: Rhegmatogenous retinal detachments

Gratitude to Dr. Kreissig and Tubingen Group

Page 26: Rhegmatogenous retinal detachments

Salute to my TEACHER

Thank you SIR

Page 27: Rhegmatogenous retinal detachments

79 Year Male Psuedoph. Upper Temp HST

Page 28: Rhegmatogenous retinal detachments

30 Yr Male, 15 month old Trauma Inferior HST