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    Scleral buckle technique using PPV, laser photocoagulation


    Good patient response

    My patients respond well to this technique regardless of laser probe. However, when using a laser probe that is too large or bulky, it can be difficult to aim the beam into some areas of the eye.

    For many years, I used laser probes from Alcon Laboratories and Iridex. Recently, I began using the Adjustable & Intuitive Extended Reach (A&I XR, IRIDEX) laser probes, and have found that they offer better control. In my experience, I have noticed increased efficiency and reduced complications.

    These adjustable probes are extendable and, compared to standard laser probes, provide a farther reach by altering the probe from a straight configuration into a curved configuration. The far-reaching curve enables me to cover a greater range of angles, reaching areas that were difficult or impossible to treat without changing probes.

    For instance, some areas posterior to the buckle indentation on the inside of the eye are difficult to reach with traditional laser probes. With the extended curve of the adjustable probe, I can deliver laser treatment, then turn the laser probe upside down and it will reach the area beneath the buckle.

    In addition, the probe’s tighter cone lets me to adjust how close I am to the retina, which allows for increased ease of focus at a safer distance without sacrificing laser power. All of these features add up to more efficient and better anterior treatments.

    Once endolaser is complete, I insert a gas bubble inside the eye, typically 14% C3F8, and then close the eye.

    On occasion, if I cannot reach the retinal tears, I will utilize an indirect laser before closing. Prior to the adjustable probe, I would need to do this in about 80% of my cases. With the adjustable probe, this is rarely necessary.

    Increased efficiency


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