Chapter 12

Combined Vitrectomy and Scleral Buckle

In some circumstances when a vitrectomy is to be performed, an additional scleral buckle may be considered as a combined procedure. Indications are controversial but may include:

  1. Repeat retinal detachment following vitrectomy only
  2. Proliferative vitreoretinopathy (PVR), particularly if peripheral (and especially if inferior)
  3. Phakic patients (where it is harder to shave the vitreous base and remove sufficient vitreous)
  4. Difficulty visualizing the periphery (vitreous haemorrhage, cortical cataract, posterior capsular opacification)
  5. Inferior breaks (gas or silicone oil endotamponades that float may be less effective)
  6. Significant vitreous base / anterior loop traction (evident during vitrectomy)

Figure 12.1 Vitrectomy-Scleral Buckle
An encircling band has been passed around the eye prior to vitrectomy. Here the retinal tear can be seen to sit on the indentation of the scleral buckle. The vitrectomy cutter is being used to relieve vitreous traction off the break.

Scleral Buckle or Vitrectomy First?

All rights reserved. No part of this publication which includes all images and diagrams may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the authors, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.

Westmead Eye Manual
This invaluable open-source textbook for eye care professionals summarises the steps ophthalmologists need to perform when examining a patient.

© 2022 VITREORETINAL SURGERY ONLINE

Website by WebInjection