2 new possibilities for using balloon occlusion in relation to the indentation effect

Abstract

Two new applications of the balloon are described which exploit its variable indentation: in the first case, the volume is reduced by withdrawal of fluid; in the second it is increased by additional injection. In both cases the procedure consists in two steps performed in subconjunctival anesthesia. In the first case the balloon provides intraocular space prior to gas injection (giant tear detachment). In the first step the balloon is inserted into the parabulbar space. After one to two hours this results in a deep indentation of the globe. In the second step the balloon indentation is used to compensate for the rise in IOP induced by the gas injection. With this "balloongasprocedure", a kind of fluid-gas-exchange is performed by injecting 1.0 ml of an expanding perfluorocarbon gas without prior drainage or pars plana vitrectomy. In the second case, the balloon is used in cases of detachment to interrupt retinal circulation prior to occlusion of a recurrently hemorrhaging vessel using the laser. In the first step, the tear is tamponaded by the parabulbar balloon and with this, the artery crossing the horseshoe tear is attached as well. In the second step, by increasing the balloon volume, retinal circulation is interrupted prior to occlusion of the artery by laser with reduced risk of hemorrhage. In both applications of the balloon a relatively complex detachment operation is divided into two smaller principle of less risky procedures on the surgery in small steps.