ABSTRACT

In 1931, J. Gonin presented his original concept that retinal detachment is caused by a retinal break and reattachment could be achieved by inducing inflammation around the break with diathermy and by simultaneous draining of subretinal fluid. The primary advantage of cryosurgery is the ability to penetrate the sclera and to create a retinal adhesion without causing scleral necrosis. The early ophthalmoscopic appearance of a cryosurgical lesion is a function of retinal transparency. The reluctance to employ cryosurgery was the uncertainty of the strength of the cryopexy-induced adhesion. Cryosurgery allows retinal coagulation through full-thickness sclera without scleral damage and thus allows a minimal extraocular procedure for retinal detachment that employs an elastic explant to buckle the area limited to the retinal break. The pattern of the healed retinal cryosurgical lesion depends on the depth of thermal necrosis created by the cryopexy application and the extent of the basement membrane interruption.