DRAINAGE OF SUBRETINAL FLUID IN RETINAL-DETACHMENT SURGERY WITH THE EL-MOFTY INSULATED DIATHERMY ELECTRODE

Purpose: A technique that uses the El-Mofty/Schepens diathermy tip (MI RA, Inc.) to effect drainage of subretinal fluid during scleral buckli ng surgery is described. The efficacy of this drainage technique and i ts complication rate in a series of consecutive patients is discussed. Methods: The study included all of the scleral buckling procedures pe rformed at the Retina Service for retinal detachments in which this te chnique was used. The El-Mofty/Schepens diathermy tip was first used t o cauterize the choroid at the drainage site at low power, thus render ing it avascular, and then at higher power, to cause vaporization of t he choroid, and allow spontaneous drainage of subretinal fluid. The su ccess rate and all intraoperative and postoperative complications were recorded. Results: This technique achieved successful spontaneous dra inage in 53 (82.8%) of 64 consecutive cases. Complications that are oc casionally associated with the drainage of subretinal fluid, including iatrogenic retinal holes, choroidal hemorrhage, and retinal incarcera tion in the sclerotomy site, were not seen in any of the cases. Conclu sion: This method provides a simple and safe technique for the drainag e of subretinal fluid that obviates the need to directly perforate the choroid.