Late results of cerclage operation for retinal detachment.

Developments in the surgery of retinal detachment since the time of Gonin have led from simple to more complicated methods which are not always more effective. Among the simple methods is the cerclage operation, developed by Arruga, in which a string of Supramid thread is sewn around the eyeball on the sclera and a sharp buckle is created, thus diminishing the volume of the eye and separating the region of the holes from the healthy area of the retina. In our department we have modified the Arruga method by using two parallel strings of Supramid sutures. They are applied after the holes have been treated with diathermy, thus achieving a more complete separation of the region of the holes from the central and peripheral areas. The holes lie between the two sutures which create a buckle which protrudes into the eye with the holes lying on the crest of the buckle. The Figure shows the difference between the single-string and double-string methods. The single string separates the region of holes from the central part of the retina and our double strings separate the holes both from the central part of the retina and from the periphery. (ai~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FIGURE Single cerclage (Arruga) on left. Double cerclage (Hauer) on right The Arruga operation is simple and does not take long to perform, and the results are as good as those of more complicated methods. Its chief disadvantage is that the suture may penetrate the sclera and enter the vitreous, thus causing a total nonoperable detachment. In the series described below this happened in only one case, that of a patient with blue sclera. Another disadvantage is the anterior segment necrosis that may follow all kinds of encircling procedures.