Skip to main content
Published Online:https://doi.org/10.3928/23258160-20130213-02

Abstract

BACKGROUND AND OBJECTIVE:

External drainage of subretinal fluid as part of a scleral buckling procedure rapidly restores the retinal pigment epithelium–neural retina interface in rhegmatogenous retinal detachments but carries the inherent risk of subretinal hemorrhage and retinal incarceration. The authors investigated variations to the technique to reduce the chance of subretinal hemorrhage originating from the choroid.

MATERIALS AND METHODS:

A novel method for needle drainage using electrocautery of the sclerochoroidal layers before puncture was employed. The effect of 0% to 50% scleral electrocautery in a porcine model was investigated.

RESULTS:

A significant decrease in choroidal vessel diameter and choroidal vessel density at 40% electrocautery was demonstrated.

CONCLUSION:

Electrocautery without scleral cut-down before external drainage of subretinal fluid likely decreases the chance of subretinal hemorrhage by decreasing choroidal vascularity.

[Ophthalmic Surg Lasers Imaging Retina. 2013;44:176–180]

  • 1.Haimann MH, Burton TC, Brown CK. Epidemiology of retinal detachment. Arch Ophthalmol. Feb1982; 100(2):289–29210.1001/archopht.1982.01030030291012.

    Crossref MedlineGoogle Scholar
  • 2.Michels RG. Scleral buckling methods for rhegmatogenous retinal detachment. Retina. 1986; 6(1):1–4910.1097/00006982-198600610-00002.

    Crossref MedlineGoogle Scholar
  • 3.Hilton GF, Grizzard WS, Avins LR, Heilbron DC. The drainage of subretinal fluid: a randomized controlled clinical trial. Retina. 1981; 1(4):271–28010.1097/00006982-198101040-00002.

    Crossref MedlineGoogle Scholar
  • 4.Ibanez HE, Bloom SM, Olk RJ, et al.External argon laser choroidotomy versus needle drainage technique in primary scleral buckle procedures. A prospective randomized study. Retina. 1994; 14(4):348–35010.1097/00006982-199414040-00010.

    Crossref MedlineGoogle Scholar
  • 5.Bovey EH, Gonvers M. [Retinal detachment and laser drainage]. Klin Monbl Augenheilkd. 1995; 206(5):332–33510.1055/s-2008-1035455.

    Crossref MedlineGoogle Scholar
  • 6.Jaffe GJ, Brownlow R, Hines J. Modified external needle drainage procedure for rhegmatogenous retinal detachment. Retina. 2003; 23(1):80–8510.1097/00006982-200302000-00013.

    Crossref MedlineGoogle Scholar
  • 7.Azad R, Kumar A, Sharma YR, Rajpal . Modified needle drainage. A safe and efficient technique of subretinal fluid drainage in scleral buckling procedure. Indian J Ophthalmol. 2004; 52(3):211–214.

    MedlineGoogle Scholar
  • 8.Kitchens JW. Modified external needle drainage of subretinal fluid in the management of rhegmatogenous retinal detachment using a “guarded needle” approach. Arch Ophthalmol. 2011; 129(7):949–95110.1001/archophthalmol.2011.165.

    Crossref MedlineGoogle Scholar
  • 9.Kim JH, Bertram KM, Quirk MT, Arroyo JG. Modified external needle drainage of subretinal fluid in primary rhegmatogenous retinal detachment: a prospective, consecutive, interventional, single-surgeon study. Retina. 2007; 27(9):1231–123710.1097/IAE.0b013e318068de5c.

    Crossref MedlineGoogle Scholar
  • 10.Spraul CW, Lang GE, Grossniklaus HE, Lang GK. Histologic and morphometric analysis of the choroid, Bruch’s membrane, and retinal pigment epithelium in postmortem eyes with age-related macular degeneration and histologic examination of surgically excised choroidal neovascular membranes. Surv Ophthalmol. 1999; 44Suppl 1:S10–3210.1016/S0039-6257(99)00086-7.

    Crossref MedlineGoogle Scholar
  • 11.Olsen TW, Sanderson S, Feng X, Hubbard WC. Porcine sclera: thickness and surface area. Invest Ophthalmol Vis Sci. 2002; 43(8):2529–2532.

    MedlineGoogle Scholar
  • 12.Nicoli S, Ferrari G, Quarta M, et al.Porcine sclera as a model of human sclera for in vitro transport experiments: histology, SEM, and comparative permeability. Mol Vis. 2009; 15:259–266.

    MedlineGoogle Scholar
  • 13.Foos RY. Tears of the peripheral retina; pathogenesis, incidence and classification in autopsy eyes. Mod Probl Ophthalmol. 1975; 15:68–81.

    MedlineGoogle Scholar
  • 14.Burton RL, Cairns JD, Campbell WG, Heriot WJ, Heinze JB. Needle drainage of subretinal fluid. A randomized clinical trial. Retina. 1993; 13(1):13–1610.1097/00006982-199313010-00004.

    Crossref MedlineGoogle Scholar
  • 15.Jabbour NM, McCormick SA, Gong HY. Transscleral and transconjunctival diathermy. Retina. 1989; 9(2):127–13010.1097/00006982-198909020-00011.

    Crossref MedlineGoogle Scholar
  • 16.Bhatt N, Peyman GA, Karacorlu M. Scleral damage: comparison of standard and modified diathermy electrodes. Int Ophthalmol. 1993; 17(5):255–25810.1007/BF01007792.

    Crossref MedlineGoogle Scholar
  • 17.Raymond GL, Lavin MJ, Dodd CL, McLeod D. Suture needle drainage of subretinal fluid. Br J Ophthalmol. 1993; 77(7):428–42910.1136/bjo.77.7.428.

    Crossref MedlineGoogle Scholar

We use cookies on this site to enhance your user experience. For a complete overview of all the cookies used, please see our privacy policy.

×