The authors describe a modified technique for scleral buckling by which a wide retinal tear can be closed with a relatively narrow buckle. An incomplete cut on the silicone sponge can be made so that the halves are connected to each other by a narrow strip of material and opened like a book when buckling. Using this open-book technique, silicone sponges can be used to close horseshoe-shaped retinal tears of one to two times the width of available silicone sponges. This technique was used in four eyes with excellent anatomical results, and no complications could be attributed to the surgical technique. This technique provides an alternative treatment strategy for retinal detachment with relatively wide retinal tears.
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