case_images: PMC11834910_01
case_images: Surgical technique for scleral imbrication. (a) Conjunctival peritomy with bridling of recti muscles; (b) scleral box sutures; (c) 2-3 sutures in the superotemporal quadrant; (d) vitrectomy; (e) scleral indentation and tightening of sutures; (f) scleral infolding seen; (g) scleral infolding in the lower quadrant; (h) retinotomy with fluid gas exchange; (i) silicone oil infusion
case_images: IJO-73-172-g001.jpg
case_images: PMC11834910_01_IJO-73-172-g001.jpg
case_images: IJO.IJO_211_24-F1
case_images: A complete conjunctival peritomy was done, and the recti muscle (inferior, lateral, and superior) was bridled with 5-0 silk [Fig. 1a]. Then we passed partial-thickness scleral box sutures using 5-0 polyester about 9-10 mm apart anteroposteriorly [Fig. 1b]. We placed two sutures in the inferotemporal quadrant and three in the superotemporal quadrant [Fig. 1c]. Following core vitrectomy, we did peripheral base excision at low vacuum (50 mm Hg) and high cut rate/min [5000; Fig. 1d]. The surgeon tightened the suture over it, and knots were finalized [3-2-1 knot; Fig. 1e and f]. We noticed scleral infolding under the sutures [Fig. 1g]; this scleral imbrication procedure causes scleral shortening. Then we made a draining retinotomy nasal to the disc and did fluid gas exchange [Fig. 1h], followed by an endolaser around the retinotomy and causative break and 360 degrees posterior to the scleral indent and ora serrata nasally. This was followed by silicone oil infusion [1300 Cst; Fig. 1i] and the closure of sclerotomies and conjunctiva.
case_images: Color fundus photo of RE (a) and LE (b) after scleral imbrication showing temporal indentation of retinochoroidal layers (black arrow)
case_images: IJO-73-172-g002.jpg
case_images: PMC11834910_01_IJO-73-172-g002.jpg
case_images: IJO.IJO_211_24-F2
case_images: The posterior pole retina was attached to staphyloma and was thin with underlying choroidal thinning [Fig. 2a]. The retinal fold was noted temporally due to scleral shortening [Fig. 2b, white arrow].