[Intraocular complications following Custodis-Lincoff operation].

Abstract

This investigation is based on 262 cases of retinal detachment treated with episcleral silastic sponge implants and cryopexy. Anatomical restoration of the retina after one operation or more was successful in 89 percent. Drainage of subretinal fluid was carried out in 52 percent of the cases. Supplementary light-coagulation 3 or 4 weeks after the operation was applied in 43 cases (17 percent) in order to seal off retinal holes on the buckle due to inadequate chorioretinal adhesion following cryopexy. Insufficient adhesion was directly related to the retinal elevation in the area of the tear. Chorioretinal haemorrhages in the group without release of subretinal fluid were caused by the following factors: Repeated cryo-application in the same place, application of the probe on the open part of the tear instead of around the tear, sponge-fixation in the immediate area to vortex veins, pressure exerted by the sponge on choroidal and retinal vessels, particularly in persons of advanced age. Local haze of the vitreous corresponding to the location of the cryp-application was directly related to the number of applications and the position of the tear. Vitreous haze was more frequent where the hole was situated towards the ciliary body. Pigment migration was observed in 9 percent of the cases. It should be noted that this complication was also encountered preoperatively in a group amounting to 4 percent of the total number of cases after padding of the eyes and absorption of subretinal fluid. Such cases should be distinguished from those of postoperative occurrence of pigment migration. Detachment of the choroid happened more often in the group in which subretinal fluid was released. In this group expulsive haemorrhage also occurred, which, apart from the choroidal detachment, resulted, immediately upon drainage of subretinal fluid, in high intracular pressure. Macular puckering was noticed in 5 cases (2,7 percent). In 4 out of the 5 cases with this complication, the tear was located towards the posterior pole and sponge fixation was radial.