Minimizing Risk in Scleral Buckle Surgery: A Novel Approach to Belt Loop Creation Using a Guarded Diamond Blade.

PURPOSE: To describe a novel technique for scleral belt loop formation during scleral buckle (SB) surgery using a guarded diamond limbal relaxing incision (LRI) blade to minimize the risk of scleral perforation and improve groove consistency.

METHODS

A conventional scleral buckle procedure was performed for rhegmatogenous retinal detachment (RRD) with the placement of a #240 encircling band. Four partial-thickness scleral grooves were created in each quadrant using a guarded diamond LRI blade with a preset depth of 150 µm. The band was passed through the resulting belt loops and secured with a Watzke sleeve. Operative efficiency, tissue resistance, and groove quality were assessed intraoperatively.

RESULTS

The guarded diamond blade enabled single-pass formation of uniform scleral grooves with minimal resistance and excellent visualization. No intraoperative complications were observed, including scleral perforation, hypotony, or hemorrhage. Groove creation was rapid and reproducible.

CONCLUSION

Use of a guarded diamond LRI blade for scleral belt loop creation provides a precise, efficient, and low-risk alternative to traditional dissection techniques. This approach may improve surgical safety and efficiency.