The fishmouth phenomenon. II. Wedge scleral buckling.

Radial retinal folding, associated with equatorial scleral buckling, contributes to the difficulty in repairing a retinal detachment due to a fishmouth break. To minimize this effect, a wedge-shaped implant was designed to approximate more closely the same relative reduction in the circumference of the circles of the globe along the meridian of the break. The surgical details of use of the implant are described. In a consecutive series of 56 eyes in which the fishmouth phenomenon was expected, 49 (88%) were successfully managed at first encounter using a wedge buckling device. Revised scleral bucklings and open-sky vitrectomies, in early failures and delayed recurrences, salvaged additional eyes for final success in 52 (93%) of the eyes.