The localized scleral indentation procedure for treatment of retinal detachment is one that we have been using with increasing frequency since first seeing it performed by Dr. Custodis in Dusseldorf in 1958.1 In recent years we have changed the materials and technique of the procedure in three ways:
By replacing the polyviol implant with silicone sponge.
By developing an improved scleral needle.
By substituting cryopexy for diathermy.
The purpose of this paper is to describe the operation with these changes.
The operation consists essentially in buckling a soft synthetic implant directly over the retinal hole. The advantages which it provides in suitable cases are that it is a limited operation, usually confined to one quadrant of the eye, no scleral dissection is required, and there is no drainage of subretinal fluid. Dr. Custodis originally used an implant of polyviol, a red rubbery substance made of polyvinyl alcohol, gum arabic
LINCOFF HA, BARAS I, McLEAN J. Modifications to the Custodis Procedure for Retinal Detachment. Arch Ophthalmol. 1965;73(2):160-163. doi:10.1001/archopht.1965.00970030162004