Department of Ophthalmology, University of Zurich School of Medicine, Zurich, Switzerland.
Surv Ophthalmol. 2013 Mar-Apr;58(2):184-95. doi: 10.1016/j.survophthal.2012.09.002. Epub 2012 Dec 17.
Retinal tears were recognized as soon as ophthalmoscopy became available. They were initially considered to be secondary events, from choroidal exudation and pressure behind the detached retina. This led von Graefe and others to recommend cuts in the retina to drain subretinal fluid into the vitreous cavity. De Wecker (1875, 1879) and Leber (1882) first proposed that intrinsic tears within the retina are the cause of retinal detachment, but they faced extreme and long lasting opposition for this view. Surgical results at this time were uniformly disastrous, and therapeutic nihilism still prevailed when Dufour and Gonin became convinced around 1904-1906 that the retinal tear was indeed the origin of the detachment. It took ten years, however, before Gonin figured out how to close tears by exact placement of heat coagulation ("thermopuncture") and provide therapeutic evidence for his beliefs. When he first presented his results in 1921, colleagues jeered at him, especially Deutschmann and Sourdille who, like the other ophthalmic surgeons, denied the role of the tear (and still made "therapeutic" incisions through the detached retina). Recognition of Gonin's approach finally came at the International Congresses in Amsterdam 1928 and in Madrid in 1933. Sourdille modified his approach when his son Gabriel convinced him to change after 1930, but Deutschmann stuck to his horrific procedure until his death in 1935. Then a new generation of retinal surgeons took over, with subsequent discussion focused on finding the best methods to close the tears.
视网膜裂孔一出现，通过检眼镜就能发现。起初，人们认为裂孔是脉络膜渗出和脱离的视网膜后面压力导致的继发事件。这使得 von Graefe 和其他人建议在视网膜上切开以将视网膜下液引流到玻璃体腔中。De Wecker（1875 年，1879 年）和 Leber（1882 年）首次提出视网膜内的固有裂孔是视网膜脱离的原因，但他们的观点遭到了极端和持久的反对。当时的手术结果一律是灾难性的，当 Dufour 和 Gonin 在 1904-1906 年左右确信视网膜裂孔确实是脱离的起源时，治疗上的虚无主义仍然盛行。然而，在 Gonin 想出如何通过精确放置热凝（“热穿刺”）来闭合裂孔并为他的信念提供治疗证据之前，又过了十年。当他于 1921 年首次展示他的结果时，同事们嘲笑他，尤其是 Deutschmann 和 Sourdille，他们像其他眼科医生一样否认裂孔的作用（并且仍然通过脱离的视网膜进行“治疗性”切口）。Gonin 的方法最终在 1928 年阿姆斯特丹和 1933 年马德里的国际大会上得到认可。当他的儿子 Gabriel 说服他在 1930 年之后改变时，Sourdille 修改了他的方法，但 Deutschmann 坚持他可怕的手术程序，直到 1935 年去世。然后，新一代的视网膜外科医生接管了，随后的讨论集中在寻找最好的方法来闭合裂孔。
