THE EXTERNAL silicone sponge implant with cryosurgery, a modification of the original Custodis polyviol implant, has become a useful technique in the treatment of retinal detachments. In this procedure, the use of scleral mattress sutures is necessary to create and maintain the resulting scleral buckle. Placement of these sutures is made especially difficult in the presence of thin sclera, posterior retinal holes, and adjacent vascular structures such as vortex veins. Where one or more of these complicating factors exist (not an unusual circumstance), the proper placement of the suture can be distinctly hazardous. In addition, a long bite through the sclera is desirable for increased holding power. This in turn increases the exposure to the possibility of hemorrhage or inadvertant perforation of the globe. The longer bite also requires a larger curved needle which increases the difficulty in placing sutures for posterior holes. Furthermore, when the suture is pulled up
Fradin S. A New Suture for External Silicone Sponge Implants. Arch Ophthalmol. 1971;86(1):58–59. doi:10.1001/archopht.1971.01000010060011
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