Scleral buckling surgery

Regmatogeno odignuće mrežnice uzrokuju retinalne rupture koje dovode do nakupljanja tekućine i posljedičnog odvajanja neurosenzorne retine i retinalnog pigmentnog epitela. Tri preduvjeta za razvoj regmatogenog mrežničnog odignuća su razrjeđenje staklovine, trakcijske sile koje dovode do stvaranja retinalne rupture, te prolaz tekućine kroz rupturu u subretinalni prostor. Predstavlja hitno stanje u oftalmologiji koje brzo može dovesti do nepovratnog oštećenja vidne funkcije. Konvencionalna operacija regmatogenog odignuća mrežnice temelji se na uspostavljanju normalnog anatomskog odnosa između senzorne retine i retinalnog pigmentnog epitela. Najvažnija vještina konvencionalne metode operacije je uočavanje svih mrežničnih ruptura, a cilj operacije njihovo zatvaranje i smanjenje mogućnosti za ponovno odignuće mrežnice. To se postiže uporabom silikonske vrpce i silikonske plombe u tijeku postupka operacije. Anatomski rezultat konvencionalne operacije regmatogene retinalne ablacije ovisi o mnogim preoperativnim i intraoperativnim čimbenicima. Najznačajniji čimbenik postoperativnog ishoda je preoperativno stanje makule. Odignuća mrežnice s prilegnutom makulom bilježe značajno bolji anatomski i vidni ishod. Prethodnih 40 godina materijali i metode konvencionalne operacije neprestano su se usavršavali, rezultirajući prilijeganjem mrežnice u visokom postotku. Tako je danas očekivana stopa prilijeganja odignute mrežnice preko 90%.A rhegmatogenous retinal detachment occurs when a break in the retina leads to fluid accumulation with a separation of the neurosensory retina from the underlying retinal pigment epithelium.Three pre-requisites for the development of rhegmatogenous retinal detachment are liquefaction of the vitreous, tractional forces that produce a retinal break, and a retinal break through which fluid gains access into the subretinal space. This is an ophthalmologic emergency that can rapidly progress to irreversible vision loss in the affected eye. Scleral buckling surgery, which is used in treatment of rhegmatogenous retinal detachment, is based on the anatomic correction of the space created between the detached sensory retina and the retinal pigment epithelium. The most important skill required in surgery for retinal detachment is the ability to detect all retinal breaks. Scleral buckling is performed to produce functional closure of retinal breaks responsible for retinal detachment and to reduce the chances of recurrent detachment. In the procedure the silicone sponge and the solid silicone band are used for encircling the eye. The anatomic result after scleral buckling for rhegmatogenous retinal detachments are dependent on many preoperative and intraoperative factors. The strongest predictor of postoperative reattachment and vision is the preoperative status of the macula. Detachments with the macula attached (macula-on) at the time of surgery have significantly better anatomic and visual result. Over the past 40 years, the materials and techniques of scleral buckling surgery have undergone continued refinement, resulting in a high rate of retinal reattachment. Today, overall reattachment rates of greater than 90% are expected