Cerclage (ophthalmology)

In ophthalmology, a surgical procedure that can be used to detach the retina is referred to as cerclage ( French: “looping”) . A narrow silicone band is usually placed around the eyeball near the equator and fastened with appropriate tension. The pressure exerted in this way causes the globe to be indented inwards, so that the detached retina can reattach itself to the inner layer. The pressure can be concentrated on certain areas by pushing small tamponades ( wedges ) under the plastic tape at the desired points . Supportive cold treatment (cryocoagulation) can be carried out to stimulate scarring.

Surgical procedures in which the eyeball is laced around were first performed in the late 1950s. In over 80% of the treatment cases, a cerclage operation leads to a reattachment of the retina. Detachment after a long and positive healing process is rare and affects about 1–2% of the operated cases.

Side effects

Since a cerclage is usually placed circularly around the eyeball, it must be passed under the external eye muscles . This can lead to a corresponding increase in tension, which in turn can trigger eye muscle imbalance disorders in some exceptional cases. The length of the eyeball can also increase as a result of the measure and so cause myopization by an average of 1.5 to 2.0 diopters.

Alternatives

An alternative to cerclage surgery, depending on the indication, is the fixation of silicone seals of different sizes on selected areas of the globe. In this case, however, the pressure does not apply in a circular manner on the entire equator of the globe, but only on a circumscribed point. A seal is therefore more suitable for treating small-area detachments or retinal holes. Cerclage and sealing operations are also called hump surgery because of their indenting effect .

An alternative method to "hump surgery" is the so-called vitrectomy .

Web links

• auge online - retinal and vitreous surgery
• Guideline No. 22b - Rhegmatogenic retinal detachment - Professional Association of Ophthalmologists in Germany (BVA)
• NPL Dang Burgener, CJ Pournaras, J. Salzmann: "Benefit of cerclage in severe rhegmatogenic ablation: a retrospective study of 41 cases". Clinical Monthly Ophthalmology 2006; 223 (5): 431-435, doi : 10.1055 / s-2006-926598

Individual evidence

1. ↑ P. Lommatzsch, H. Voigt: "About later results of the« Cerclage equatorial »according to Arruga". Ophthalmologica 1969; 159: 117-125 ( doi : 10.1159 / 000305893 ).
2. ^ "Therapy of retinal detachment:" hump surgery "is as effective as vitrectomy" - from: Deutsches Ärzteblatt 2010; 107 (33): A-1574 / B-1402 / C-1382.
3. ↑ Bopp, S. and Böhm, K .: "Reamotio more than 1 year after primarily successful ablation surgery: causes and frequency." Clinical monthly sheets for ophthalmology, 2008 Volume 225, pp. 227-235. Georg Thieme Verlag Stuttgart. doi : 10.1055 / s-2008-1027244
4. ↑ Anselm Kampik, Dorothea Besch, Franz Grehn: "Ophthalmic Therapy". Georg Thieme Verlag, 2002, pp. 199 ff. ISBN 9783131284112 .

literature

• Albert J. Augustin: Ophthalmology. Berlin: Springer Verlag, 2007, ISBN 978-3-540-30454-8 .
• Franz Grehn: Ophthalmology. Berlin: Springer Verlag, 30th edition, 2008, ISBN 978-3-540-75264-6 .

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !