SURVEY OF OPHTHALMOLOGY
VOLUME 36 * NUMBER 4. JANUARY-FEBRUARY 1992
LETTERS
which, we think, was fairly described in our article. His procedure differed from that described above in several respects and he did not choose to call it a scleral buckling. Dr. Custodis did not invent the scleral implant, because Jess (1937) used an implant before him and Strampelli (1933) obtained a similar effect by inserting a gelatin implant between sclera and choroid. Dr. Teichmann is correct in stating that Jess did not suture the gauze implant to the sclera. CHARLESL. SCHEPENS,M.D.
History of Scleral Buckling To the editor: Drs. Schepens and Acosta wrote a delightful article about scleral implants (Sure Ophthalmol 35/6, May-June 1991, pages 447-453). I enjoyed particularly the section about expandable implants, a field I had done some work on 17 years ago. Unfortunately, Dr. Schepens is still at odds with history when it comes to Dr. Custodis and his contribution to retinal surgery. It was Dr. Custodis who introduced scleral buckling procedures in 1949, and not Dr. Schepens. It was Dr. Custodis who realized long before Dr. Schepens that the extent of the buckle(s) had to fully encompass the retinal hole(s) in order to achieve reattachment. The idea of closing a retinal hole (or holes) by means of a scleral buckle is that of Custodis. Fortunately, in the beautiful book by the late Ron Michels (Michels RG, Wilkinson CP, Rice TA: Retinal Detachment. St Louis, CV Mosby, 1990) on page 282 there is a true account of the evolution of scleral buckling. There the interested reader can also find that Jess did not, as Schepens writes, “suture the gauze pad to the sclera,” but merely attached a thread to the gauze in order to permit easy removal (see page 281). KLAUS D. TEICHMANN, M.D.
FERNANDO ACOSTA,
M.D.
BOSTON, MASSACHUSETTS
Direct Canalicular
Sutures
To the editor: I greatly enjoyed the recent review, “Management of Canalicular Lacerations,” by David Reifler (Sun, Ophthalmol 35/2 (Sept-Oct):l13-132, 1991). To the best of my knowledge, I and A. Robin were the first to report the use of direct canalicular sutures with 10.0 monofilament sutures without intubation.‘-” The technique is worth mentioning, as it is a simple technique that is very useful when the laceration is near the lacrimal point and that cannot damage the non-lacerated canaliculus.
RENDSBURG,GERMANY
FR. J.F.
Authors’ response: We read Dr. Teichmann’s emphatic letter with interest. The term “scleral buckling” was coined by Schepens et al in 1957 to describe the use of scleral implants according to their technique: 1) Utilization of a well tolerated permanent implant (polyethylene tubing, and later, soft silicone rubber); 2) Scleral undermining, in the bed of which diathermy was applied; 3) Burial of the implant under the scleral flaps; 4) Release of subretinal fluid in most cases; 5) Use of an encircling element in most cases. Dr. Custodis (1953) made a major contribution
LIMOGES,
hENIS
FRANCE
References 1. Adenis JP, Robin A: La reparation des plaies canaliculaires au monofilament avec ou sans intubation? Premiers resuhats. Bull Sot O~htalmol Fr 6.7:180-181, 1981 2. Adenis JP, Robin A: Une nouvelle methode de chirurgie canaliculaire: la suture au monofilament sans intubation. Etude de 23 cas. J Fr Ophtalmol 5.8:515-518, 1992 3. Adenis JP: Management of canahcular trauma. Eye 2:223225. 1988
Author’s response: I am grateful to Prof. Adenis for bringing his work to my attention. In my review, I sought to include all historically significant and innovative 323
VOLUME 36 * NUMBER 4. JANUARY-FEBRUARY 1992
LETTERS
which, we think, was fairly described in our article. His procedure differed from that described above in several respects and he did not choose to call it a scleral buckling. Dr. Custodis did not invent the scleral implant, because Jess (1937) used an implant before him and Strampelli (1933) obtained a similar effect by inserting a gelatin implant between sclera and choroid. Dr. Teichmann is correct in stating that Jess did not suture the gauze implant to the sclera. CHARLESL. SCHEPENS,M.D.
History of Scleral Buckling To the editor: Drs. Schepens and Acosta wrote a delightful article about scleral implants (Sure Ophthalmol 35/6, May-June 1991, pages 447-453). I enjoyed particularly the section about expandable implants, a field I had done some work on 17 years ago. Unfortunately, Dr. Schepens is still at odds with history when it comes to Dr. Custodis and his contribution to retinal surgery. It was Dr. Custodis who introduced scleral buckling procedures in 1949, and not Dr. Schepens. It was Dr. Custodis who realized long before Dr. Schepens that the extent of the buckle(s) had to fully encompass the retinal hole(s) in order to achieve reattachment. The idea of closing a retinal hole (or holes) by means of a scleral buckle is that of Custodis. Fortunately, in the beautiful book by the late Ron Michels (Michels RG, Wilkinson CP, Rice TA: Retinal Detachment. St Louis, CV Mosby, 1990) on page 282 there is a true account of the evolution of scleral buckling. There the interested reader can also find that Jess did not, as Schepens writes, “suture the gauze pad to the sclera,” but merely attached a thread to the gauze in order to permit easy removal (see page 281). KLAUS D. TEICHMANN, M.D.
FERNANDO ACOSTA,
M.D.
BOSTON, MASSACHUSETTS
Direct Canalicular
Sutures
To the editor: I greatly enjoyed the recent review, “Management of Canalicular Lacerations,” by David Reifler (Sun, Ophthalmol 35/2 (Sept-Oct):l13-132, 1991). To the best of my knowledge, I and A. Robin were the first to report the use of direct canalicular sutures with 10.0 monofilament sutures without intubation.‘-” The technique is worth mentioning, as it is a simple technique that is very useful when the laceration is near the lacrimal point and that cannot damage the non-lacerated canaliculus.
RENDSBURG,GERMANY
FR. J.F.
Authors’ response: We read Dr. Teichmann’s emphatic letter with interest. The term “scleral buckling” was coined by Schepens et al in 1957 to describe the use of scleral implants according to their technique: 1) Utilization of a well tolerated permanent implant (polyethylene tubing, and later, soft silicone rubber); 2) Scleral undermining, in the bed of which diathermy was applied; 3) Burial of the implant under the scleral flaps; 4) Release of subretinal fluid in most cases; 5) Use of an encircling element in most cases. Dr. Custodis (1953) made a major contribution
LIMOGES,
hENIS
FRANCE
References 1. Adenis JP, Robin A: La reparation des plaies canaliculaires au monofilament avec ou sans intubation? Premiers resuhats. Bull Sot O~htalmol Fr 6.7:180-181, 1981 2. Adenis JP, Robin A: Une nouvelle methode de chirurgie canaliculaire: la suture au monofilament sans intubation. Etude de 23 cas. J Fr Ophtalmol 5.8:515-518, 1992 3. Adenis JP: Management of canahcular trauma. Eye 2:223225. 1988
Author’s response: I am grateful to Prof. Adenis for bringing his work to my attention. In my review, I sought to include all historically significant and innovative 323
