Effectiveness of Scleral Buckling with a Wide-Field Surgical Microscope and Chandelier Illumination in Retinal Detachment Repair

Abstract

Purpose: To assess treatment efficacy of scleral buckling surgery with wide-field surgical microscope and 27-gauge (G) chandelier illumination for rhegmatogenous retinal detachment (RRD). Methods: This study is a retrospective chart review of 29 eyes in 29 patients with RRD who underwent scleral buckling surgery with a wide-field surgical microscope and 27-G chandelier illumination fiber inserted into the sclera at the pars plana. Results are expressed as mean ± standard deviation. Data were analyzed using the paired sample t test. Statistical significance was considered if p value was less than 0.05. Results: The mean age of patients was 43.5 ± 3.5 years, and the mean follow-up time was 10.4 ± 2.5 months. Retinal reattachment was achieved in 27 of 29 eyes at initial surgery. The mean best corrected visual acuity improved from 0.38 ± 0.29 (logMAR) preoperatively to 0.19 ± 0.21 at 6 months after surgery. Two eyes underwent vitrectomy with silicone oil tamponade because of development of proliferative vitreoretinopathy. There was no complication such as choroidal hemorrhage, hypotony, or vitreous herniation at the end of surgery. Conclusion: Scleral buckling with a wide-field surgical microscope and 27-G chandelier illumination has the advantage of offering exact identification of retinal tears and determination of the adequacy of buckle height and position in retinal detachment surgery compared to conventional scleral buckling surgery.

Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

“…Recently, Frisina et al reported 213 eyes of primary RRD who underwent microscope-assisted ab externo surgery and demonstrated the safety and efficacy of this technique [ 15 ]. However, the reported studies on chandelier endoillumination-assisted scleral buckling cover a limited follow-up period, ranging from 1 to 12 months [ 3 , 16 – 21 ]. Our group applied 25-gauge cannula-based chandelier-assisted scleral buckling since 2013.…”

Scleral Buckling Using Chandelier and Releasable Suture: A Useful Surgical Variant

“…The use of EI chandelier-assisted SB technique, as was previously reported, has shown to have similar outcomes compared with conventional indirect ophthalmoscopic SB surgery for primary reattachment. 9 By the way the visualization of the retina through a wide-angle indirect system, pathologies are easier to find, marked, and treated while the surgery may become quicker. With better and, somewhat, easier visualization of the crucial parts of the surgery, the popularity of SB surgery may rise again.…”

Netzhautablösung – Teil 2

“…Heutzutage wird die Buckelchirurgie von den meisten Chirurgen auch mikroskopassistiert mit Endoillumination [2] durchgeführt, was eine präzisere Lokalisation der Befunde ermöglicht, jedoch den Nachteil des "intraokularen" Eingriffs durch das Chandelierlicht hat. Die indirekte Ophthalmoskopie zur Lochsuche entfällt, und der Befund kann bei Betrachtung durch das Mikroskop auch vergrößert dargestellt werden [2] (▶ Abb. 1).…”