In today’s episode we’ll show you how to use a segmental sponge when scleral buckling for a localized retinal detachment. Our patient has a superonasal retinal detachment associated with a PVD and a single superonasal retinal break. The patient doesn’t have any other peripheral retinal pathology on scleral depressed examination. In this type of case most people would probably opt for a primary vitrectomy with gas implantation, but this patient lives at high altitude, is from out of town, and needs to return home. We’d like to avoid using silicone oil which would require another operation down the road and since the patient is pseudophakic with pre-op vision of 20/30 without correction we’d like to avoid inducing refractive error. For these reasons we are going to use a segmental sponge. At the end of the case we discuss some tips when implanting segmental sponges and reasons to consider using a segmental buckle in select cases.
