Our Summary

This paper outlines a surgical method using a technique known as guarded-needle external drainage for many different uses in eye surgery, specifically for the back part of the eye. The authors describe the procedure in detail and provide a video to illustrate it. They also review a series of cases where patients with different eye conditions underwent this procedure.

The guarded-needle technique involves using a thin needle and a part of a surgical instrument, both connected to a machine that helps remove fluid from the eye. This technique is particularly useful in cases where there is a lot of fluid buildup in the eye, when there are small or anterior breaks, when a type of eye surgery called a scleral buckle is performed, and for preventing under-filling when using oil tamponade in cases with choroidal effusion. It can also help in draining a type of eye bleeding, in cases of diabetic eye disease, when the retina is detached without a clear break, and in extracting samples from the eye in cases of exudative detachments.

The authors conclude that this guarded-needle external drainage method is versatile and can be used in a variety of situations in eye surgery.

FAQs

  1. What is the guarded-needle external drainage technique used for in vitreoretinal surgery?
  2. How is the guarded-needle external drainage technique performed?
  3. In what types of cases is the guarded-needle external drainage technique particularly useful?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative instructions carefully, including keeping the eye clean and protected, taking prescribed medications as directed, attending follow-up appointments, and avoiding activities that could put pressure on the eye. It is important to communicate any concerns or changes in vision to the doctor promptly.

Suitable For

Patients who are typically recommended for scleral buckle surgery include those with bullous detachments, small and anterior breaks, choroidal effusion, subretinal gas/air, subretinal band, suprachoroidal hemorrhage, diabetic tractional retinal detachments, detachments with no definitive break, and exudative detachments requiring subretinal biopsy. The guarded-needle external drainage technique can be used in a wide variety of vitreoretinal surgical cases to effectively address these conditions.

Timeline

Before scleral buckle surgery:

  1. Patient presents with symptoms such as blurred vision, flashes of light, or floaters.
  2. Ophthalmologist performs a comprehensive eye exam and diagnoses a retinal detachment.
  3. Patient undergoes pre-operative evaluations such as imaging tests and blood work.
  4. Surgery is scheduled, and patient is informed about the procedure and potential risks.

After scleral buckle surgery:

  1. Patient is monitored in the recovery room for a few hours after surgery.
  2. Patient may experience some discomfort or blurred vision immediately following the procedure.
  3. Patient is discharged with instructions for post-operative care, including eye drops and follow-up appointments.
  4. Patient may need to wear an eye patch or shield for a period of time to protect the eye.
  5. Over the following weeks and months, the eye will gradually heal, and vision may improve.
  6. Patient will have regular follow-up appointments with the ophthalmologist to monitor progress and adjust treatment as needed.

What to Ask Your Doctor

  1. What is the purpose of the guarded-needle external drainage technique in scleral buckle surgery?
  2. How is the technique performed and what equipment is used?
  3. What are the potential benefits of using this technique compared to traditional methods?
  4. Are there any potential risks or complications associated with the guarded-needle external drainage technique?
  5. In what specific cases or scenarios would you recommend using this technique during scleral buckle surgery?
  6. How does the technique help address issues such as bullous detachments, small breaks, choroidal effusion, or diabetic tractional retinal detachments?
  7. What is the success rate of the guarded-needle external drainage technique in your experience?
  8. What is the recovery process like for patients who undergo scleral buckle surgery with this technique?
  9. Are there any specific post-operative care instructions or precautions that patients should follow after undergoing this type of surgery?
  10. Are there any alternative treatment options or techniques that could be considered for my specific condition?

Reference

Authors: Felfeli T, Grewal PS, Mandelcorn ED. Journal: Retina. 2023 Dec 1;43(12):2130-2133. doi: 10.1097/IAE.0000000000003483. PMID: 35604721