Heads up Sutureless Chandelier assisted scleral buckle

Abstract

Purpose This study aims to describe chandelier assisted scleral buckle (CSB) using 3D visualizing system in phakic uncomplicated Rhegmatogenous Retinal Detachment (RRD). Methods This technique was performed in 6 eyes of 6 patients with primary rhegmatogenous RD who underwent encircling circumferential scleral buckling with scleral tunnels. Heads up display 3D system was used for visualization and localization of the breaks, and Chandelier Endoillumination was used as a light source was inserted through a 27 G needle sclerotomy 3.5mm from the limbus. A partial-thickness scleral “belt-loop” tunnels in the four quadrants were created using crescent knife angle beveled (2.3 mm in width) to facilitate the smooth passage of the band a 240-silicone band as encircling circumferential buckle. Cryopexy was performed and the incision was closed with cautery or absorbable sutures. Results Primary attachment success of 5 out of 6 and overall success was 100%. No intraoperative or postoperative complications observed although fellows in training performed half the procedures. Conclusions Heads up Sutureless Chandelier assisted Scleral Buckle can achieve excellent anatomical success while improving ergonomics and training. Furthermore, it is a safe procedure with less risk of complications and retinal phototoxicity.

Long-term Complications of Conventional and Chandelier-Assisted Scleral Buckle for Primary Repair of Rhegmatogenous Retinal Detachment

“… 6 7 For this reason, clinical studies investigating the results of improved vitreoretinal illumination and visualization techniques in scleral buckle surgery with wide-angled visualization, heads-up surgery, and 3D visualization platforms have become more popular. 9 10 This study also contributes to the literature reporting the outcomes of wide-angled visualization with chandelier endo-illumination method in scleral buckle surgery.…”

Intractable Pain and Diplopia After Scleral Buckle Surgery

“…Scleral belt loop tunnels are becoming increasingly popular for securing the encircling band to the sclera. [4][5][6][7] Spontaneous dehiscence of scleral loop tunnels is rare. Fukumoto et al 8 reported a patient who presented with mild foreign body sensation and visible silicone band under the conjunctiva one year after a combined pars plana vitrectomy and SB surgery.…”

“…2,3 The method has recently gained popularity as more SB procedures are performed under microscopy, as a "sutureless" surgery, or using 3D visualization systems. [4][5][6][7] In this method, the encircling buckle material is anchored to sclera through a partial thickness circumferential scleral tunnel that is usually dissected using a crescent knife. Globe perforation through full-thickness None of the authors has any financial/conflicting interests to disclose.…”

Outcomes of Chandelier-Assisted Scleral Buckling in Rhegmatogenous Retinal Detachments: Systematic Review and Meta-analysis

“…Since then, several studies have examined the efficacy of chandelier-assisted scleral buckling surgery, with some studies also comparing it to standard scleral buckling. 2,5,6,8,10–35 The advent of chandelier scleral buckling has helped improve the identification of retinal breaks that may have been previously missed in the preoperative examination when performing standard scleral buckling. 6 Chandelier scleral buckling also has the added benefit of potentially improving visualization in pseudophakic eyes.…”