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Dr. John M. McLean: Dr. Clark, in which cases would you use a scleral resection as a primary procedure? Why are scleral shortening operations better than classical diathermy in these cases?
Dr. Graham Clark: For the purposes of this discussion, all detachments may be divided into three categories:
"Simple detachments," or those which will reposition themselves on removal of the subretinal fluid.
"Complicated detachments," or those in which mechanical forces, such as retinal shrinkage, surface membranes, persistent strong vitreous traction, or agglutinated retinal folds, prevent the retina from repositioning itself against the wall of the eye.
"Borderline," or "doubtful," detachments, or those in which the surgeon does not have sufficient evidence to put them in Class 1 or 2 or those with the retina under weak vitreous traction, which, while allowing the retina to get back to the wall, will, by the persistence of its pull, redetach it.
McLean JM, Clark G, Schepens CL, Shafer DM, Shipman JS. JOINT MEETING OF NEW YORK SOCIETY FOR CLINICAL OPHTHALMOLOGY WITH NEW YORK ACADEMY OF MEDICINE, SECTION OF OPHTHALMOLOGYJan. 17, 1955 SYMPOSIUM ON RETINAL DETACHMENT. AMA Arch Ophthalmol. 1955;54(1):143-156. doi:10.1001/archopht.1955.00930020145016