O'Connor P R
Int Ophthalmol Clin. 1976 Spring;16(1):107-26. doi: 10.1097/00004397-197601610-00011.
Scleral buckling without drainage of subretinal fluid is a technique suitable to a broad range of detachment problems including aphakia, vitreous traction, multiple tears, high myopia, and large breaks, as well as old or extensive detachment. Retinal detachments operated on by modification to the Custodis procedure reattach in a spontaneous and predictable manner determined by the patient's age, the duration of the detachment, and its extent. Ninety percent of cases are completely reattached four days following surgery. Clues to successful surgery when subretinal fluid persists are retinal tear closure, documented daily fluid loss, macular reattachment, and dependent shifting of subretinal fluid. When uncertainty still exists, the final objective evaluation is the observation that fluid fails to accumulate beneath the retina when the patient is unpatched and mobilized. The operation is extraocular and avoids the problems of drainage-choroidal hemorrhage, retinal incarceration, vitreous loss, and restoration of hypotony. The technique offers the modern surgeon a simple, direct, and rational approach applicable to 75 percent of retinal detachments, and it also assures a smooth, uncomplicated recovery.
不排视网膜下液的巩膜扣带术是一种适用于多种脱离问题的技术，包括无晶状体眼、玻璃体牵拉、多个裂孔、高度近视、大裂孔以及陈旧性或广泛性脱离。通过改良 Custodis 手术治疗的视网膜脱离会以一种自然且可预测的方式复位，这取决于患者的年龄、脱离的持续时间及其范围。90%的病例在术后四天完全复位。当视网膜下液持续存在时，手术成功的线索包括视网膜裂孔闭合、记录的每日液体丢失、黄斑复位以及视网膜下液的重力性移位。当仍存在不确定性时，最终的客观评估是观察到患者未包扎且活动时液体未在视网膜下积聚。该手术为眼外手术，避免了引流相关的脉络膜出血、视网膜嵌顿、玻璃体丢失以及恢复低眼压等问题。该技术为现代外科医生提供了一种简单、直接且合理的方法，适用于 75%的视网膜脱离，并且还确保了顺利、无并发症的恢复。
