A Scleral Buckling Procedure.

THE past few years have seen the rapid development of scleral buckling procedures for the treatment of retinal separation (Cavka, 1959; Schepens, Okamura, and Brockhurst, 1957; Schepens, Okamura, Brockhurst, and Regan, 1960; Fison, McAuley, Meyer-Schwickerath, and Trevor-Roper, 1960). About 6 years ago I first used the lamellar scleral flap to cover the area of resection. The flap covered the knots of the sutures and so helped the formation of a ridge. By folding the flap into the area of resection, Cavka used the sclera to form an implant. The implant was, however, too soft to form a permanent ridge and its permanency depended upon the sutures holding. Re-operation at sites of lamellar resection show that the area has in a short time resumed its spherical shape. Possibly the constant movement of the eye within the orbital fat has a spherical moulding action. Several procedures use rigid and semi-rigid (silicone) substances and in some cases the lamellar flap has been utilized to cover or retain them (Schepens and others, 1957, 1960; Regan, Schepens, Okamura, Brockhurst, and McMeel, 1962). Disadvantages in the use of foreign bodies as scleral implants are these: