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KMID : 0360219750160020102
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Journal of the Korean Ophthalmological Society
1975 Volume.16 No. 2 p.102 ~ p.111
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The Retinal Detachment Surgery Utilizing Human Tissues I. Intrascleral Plombage Vs. Encircling buckle : on the Surgical Technique, Indication and Results
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金翔厦/Kim, Sang-Ha
金相信/Kim, Sang-Shin
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Abstract
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Conserved human sclera and autogenous or allogenous fascia lata have been used as implant material in 42cases.in which the employment of an intrascleral plombage or an encircling buckle procedure was positively indicated. Allogenous tissues were preserved in Park´s Alcohol-Glycerin No.2 Solution (50% ethyl alcohol and 100 °o glycerin mixed in a two to one ratio) for an indefinite time. Park´s A-G No. 2 Solution is considered suitable to store the human tissues for the allograft, this solution caused no special problems in our series.
The various techniques employed are illustrated and described, The intrascleral plombage was modified from the pocket technique. A linear half-thickness incision was made on the sclera over the retinal hole and then the sclera was undermind lamellary on each side. After applications of cryothermy or diathermy to the lamellar bed, preserved human sclera or fascia lata was burried in the lamellary dissected sclera. The size of the chorioretinal buckle depends on the amount of the tissue introduced intrasclerally and the suture site of the superficial scleral flaps. The encircling buckle procedure with fascia lata followed the Crock and Galbraith technique modified from Schepens.
Although there is no uniformity of opinion as to precise indication for the technique of the retinal detachment surgery, the authors used the intrascleral plombage procedure in the case of the simple total posterior vitreous detachment and the encircling buckle procedure in the total posterior vitreous detachment with collapse. The authors based their decision on the theoretical basis of the effect of the posterior vitreous detachment on the retinal detachment.
The choice of these technique is appropriate because of the high rate of anatomical reattachment of the retina.
We observed no complication even in a special retinal detachment surgery such as retina] detachment due to angiomatosis retinae, transscleral magnet extraction of the intracoular foreign body combined with retinal detachment surgery etc., even though these procedures resulted in the transplanted fascia lata or sclera coming in contact with intraocular tissue due to the exposure of choroid, retina or vitreous.
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