Título / Title

PARS PLANA AS A DRAINAGE PATHWAY IN SCLERAL BUCKLING SURGERY: A NEW TECHNIQUE

Introdução / Purpose

To describe an alternative surgical technique for the management of rhegmatogenous retinal detachments using pars plana approach as the pathway to drainage of the subretinal fluid in the primary scleral buckling surgery.

Material e Método / Methods

Surgical technique: the retinal tear is located using 25G chandelier and wide-angle viewing system (BIOM®). Cryotherapy is then performed. Scleral tunnels are made. A silicone strip was using fot buckling. The use of 30G needle, introduced via pars plana, coupled with silicone hose and a 5 ml syringe, allows controlled drainage of the subretinal fluid. The needle is introduced via a pars plana to 3.5 or 4 mm from the limbus, and its bevel reaches the subretinal fluid through primary rupture or through a small tear made by the surgeon. During active aspiration, the needle tip ie redirected in the subretinal space according to the level of subretinal fluid in order to avoid retinal perforation. The liquid is then drained without the need of conventional open drainage technique.

Resultados / Results

The described technique allows drainage of subretinal fluid and surgical success using a safer alternative drainage pathway. This technique allows the reduction of the risk of retinal incarceration and subretinal hemorrhage through a simple drainage mechanism, with low cost and simple accomplishment.

Discussão e Conclusões / Conclusion

It is important to propose new techniques to reduce surgical risks and surgery-time in patients with rhegmatogenous retinal detachment. In cases that scleral buckling is indicated, the drainage of subretinal fluid via pars plana is a technique that allows the same results of conventional surgery, with a lower surgical risk for the patient, fast procedure, low cost materials and simple technique.

Palavras Chave

Scleral introflexion; retinal detachment; pars plana; drainage.