JAN 25, 2024
Limbal-Sparing Scleral Buckle
AAO 2023 Video Program
Retina/Vitreous
Purpose: To describe a novel scleral buckling (SB) technique without 360-degree limbal conjunctival peritomy during vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Method: Four radial conjunctival incisions were performed between recti muscle insertion. Traction sutures were placed, and four belt-loop scleral tunnels were created. A 41-silicone band was passed under the belt loops and muscles with minimal conjunctival manipulation. Silicone band was secured with 72-sleeve. PPV was performed, and conjunctival incision was closed at the end of surgery. Results: All surgeries were accomplished without a limbal peritomy. Postoperative concerns like hemorrhage, pain and suture irritation were limited. None of the patients developed postoperative strabismus, diplopia, buckle infection or significant chemosis. Conclusion: Sparing the limbal conjunctiva can be helpful for future glaucoma surgery and will limit limbal stem cell loss. This technique may be beneficial in post-trabeculectomy patients. Disadvantages include limited field of view with possible increase of surgical time.