Scleral buckling without thermal adhesion.

One hundred seventy-five consecutive and unselected patients with retinal detachment were treated with a scleral buckling procedure without inducing a thermal adhesion. In 143 (82%) of these patients reattachment was successful after one operation. In 32 patients (18%) reattachment was not initially successful. These failures resulted from buckle malposition, periretinal proliferation, new or missed breaks, and the inability to close giant tears. Fifteen of the 32 reattached after subsequent scleral buckling without thermal adhesion. Final success was achieved, therefore, in 158 (90%) of the original group of 175 cases. We concluded that a chorioretinal scar might have prevented initial failure only in those cases of buckle malposition. The high incidence (17, [10%]) of periretinal proliferation, accounting for all of our final failures, did not concur with or support previous impressions indicating a causal relationship between thermal treatment and proliferative complications.