Traumatic retinal detachment--mechanisms and management.

Experience has shown that the overwhelming majority of traumatic retinal detachments are rhegmatogenous in origin. Retinal breaks are predominantly located within the vitreous base region but may occur at sites of focal scleral impact or from posterior vitreous avulsion. Although the use of scleral buckling techniques alone may be sufficient, closed microsurgery may be required to relieve trans-gel or surface retinal traction and to facilitate the identification and permanent closure of retinal breaks. Prophylactic measures including the use of closed microsurgery play a vital role in the management of traumatic retinal breaks and prevention of complex retinal detachment.