Drainage of subretinal fluid in retinal detachment surgery with the El-Mofty insulated diathermy electrode

Purpose: A technique that uses the El-Mofty/Schepens diathermy tip (MIRA, Inc.) to effect drainage of subretinal fluid during scleral buckling surgery is described. The efficacy of this drainage technique and its complication rate in a series of consecutive patients is discussed. Methods: The study included all of the scleral buckling procedures performed at the Retina Service for retinal detachments in which this technique was used. The El-Mofty/Schepens diathermy tip was first used to cauterize the choroid at the drainage site at low power, thus rendering it avascular, and then at higher power, to cause vaporization of the choroid, and allow spontaneous drainage of subretinal fluid. The success rate and all intraoperative and postoperative complications were recorded. Results: This technique achieved successful spontaneous drainage in 53 (82.8%) of 64 consecutive cases. Complications that are occasionally associated with the drainage of subretinal fluid, including iatrogenic retinal holes, choroidal hemorrhage, and retinal incarceration in the sclerotomy site, were not seen in any of the cases. Conclusion: This method provides a simple and safe technique for the drainage of subretinal fluid that obviates the need to directly perforate the choroid.