An elastic pouch operation for large retinal tears.

An episcleral pouch operation that uses Dacron-reinforced silicone sheeting for the patch and silicone sponge pellets for the stuffing has been used to extend the localized radial buckling technique to retinal detachments that are caused by breaks that span a circumferential arc between 40 degrees and 70 degrees. Nineteen of 20 retinal detachments responded favorably to the operation, 14 without drainage of subretinal fluid. When the pouch was extended circumferentially to apply to detachments caused by breaks greater than 70 degrees, it failed in six of seven patients because a radial configuration could no longer be maintained. The substitution of transparent silicone sheeting for donor sclera facilitates the fitting and stuffing of the pouch.