Retinal detachment treated with encircling silastic sponge. Further experience.

This technique, which has already been described in detail (Chawla, 1970), was used on two aphakic eyes which had already undergone unsuccessful surgery for retinal detachment and had shown early signs of preretinal retraction. Briefly, a 7 mm. silastic sponge is halved lengthwise to produce a broad shallow implant. Monitored cryopexy is applied to the retinal tears and any suspect areas. Subretinal fluid is released as completely as possible through a meridional scratch incision, the sponge is sutured circumferentially with 5/o Ethiflex (Ethicon No. Special 135/70) on a micropoint spatulated 8mm. half-circle needle, and its ends are secured with a clove-hitch ligature. Any extra reaction required can be produced with the light coagulator. Since the first two cases were reported, several patients have presented with retinal detachments in which particular features called for a special approach, and this procedure has now been employed in twelve cases (I3 eyes). (See Table, overleaf). All patients were examined with the binocular indirect ophthalmoscope, a +30 D aspheric lens, and scleral depression, and all were treated with the same basic procedure described above. Manoeuvres peculiar to each case are noted in the following case reports. In all but Case 3 the retinae have remained flat and useful vision has been retained. The minimum follow-up period to date is 6 months.