Welcome to Retina Rounds Episode 1! This episode is dedicated to my mentor, Dr. Allan “Buzz” Kreiger, a master of scleral buckling. This is a 22 year old highly myopic male with a non-PVD macula-involving rhegmatogenous retinal detachment. In this episode we review the basic steps of scleral buckling with particular attention to subretinal fluid drainage. Subretinal fluid drainage isn’t always necessary, for example in shallow retinal detachments where the retinal break can be closely apposed to the buckle. Even in bullous retinal detachments, some surgeons prefer not to drain fluid since a buckle alone can relieve traction on the break and alter fluid dynamics, allowing the RPE to pump out subretinal fluid without additional intervention. In this case, subretinal fluid drainage was performed to expedite re-attachment of the macula and restore vision. While there are a number of techniques for subretinal fluid drainage, the scleral cut-down technique shown here can decrease the chance of hemorrhage at the time of drainage. If you have a different technique for drainage, please send us your video and we will feature it in an upcoming episode. Also, please provide comments below, especially tips for improved safety and surgical success. Our patients do better when we learn from each other!
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