Minimal In Situ Conjunctival Incision for Segmental Scleral Buckling Surgery

BACKGROUND AND OBJECTIVE: To introduce a modified technique for minimal segmental buckling through a small in situ conjunctival opening for minimally invasive repair of uncomplicated rhegmatogenous retinal detachment. PATIENTS AND METHODS: This technique was performed in 46 eyes of 46 patients with primary retinal detachment. Transconjunctival traction sutures were placed in four rectus muscles after retrobulbar anesthesia was administered. After transconjunctival location of the retinal break, a 5- to 6-mm radial conjunctival incision was performed corresponding to the retinal break without cutting the limbal conjunctiva-Tenon's capsule. After cryopexy, a minimal explant was fixed with one to two sutures through the conjunctival opening, expanded by a pediatric speculum. The incision was closed via layered closure. RESULTS: Retinal reattachments were achieved with correct buckle positions in all 46 cases, with rapid cosmetic recovery. CONCLUSION: This modified minimal segmental buckling technique simplifies the buckling procedure, minimizes surgical invasiveness, and preserves an intact limbal conjunctiva.