Outcomes of scleral buckling using chandelier endoillumination

Hu, Yuntao; Si, Shancheng; Xu, Ke; Chen, Hui-Jin; Han, Liang; Wang, Xin; Ma, Zhizhong

doi:10.1111/aos.13326

Cited by 30 publications

(35 citation statements)

References 19 publications

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“…Furthermore, the only failed case of the control group was caused by an omitted hole. The better visualization of endo-illumination and noncontact wide-angle viewing system could reduce recurrence rate by sealing all retinal holes, even those that were not identified preoperatively, and make SB an option for the cases with small pupils or opacity of refractive media [10]. (2) The improved procedure had a shorter mean operation duration than conventional surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Despite zero occurrences in our study, the complications reported in previous literature should be considered, such as vitreous herniation from sclerotomy sites, vitreoretinal traction [6], endophthalmitis [15], iatrogenic retinal tears, or lens damage [5]. To reduce the complications, some points should be emphasized: (1) avoid inserting the illuminator probe into vitreous repeatedly, (2) avoid moving the probe rapidly and over-inserting, (3) do not stir vitreous, (4) examine the closure of sclerotomy site in case of vitreous herniation from sclerotomy sites and secondary vitreoretinal traction, (5) chandelier endo-illuminators might be another choice for limited insertion depth and less possible stir [10, 16].…”

Section: Discussionmentioning

confidence: 99%

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Endo-Illumination-Aided Scleral Buckling Combined with Intravitreal Injection of Hyaluronate for Treatment of Rhegmatogenous Retinal Detachment

Zhao¹,

Yan²,

You³

et al. 2020

Ophthalmologica

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Purpose: To evaluate the efficacy and safety of 25-gauge illumination-aided scleral buckling (SB) combined with hyaluronate injection for the treatment of rhegmatogenous retinal detachment (RRD). Methods: Forty-five cases were included in this retrospective study. Twenty-five cases of the treatment group received SB with the aid of endo-illumination and noncontact wide-angle viewing system combined with hyaluronate injection after subretinal fluid drainage, while 20 cases of the control group received conventional SB with binocular indirect ophthalmoscope combined with air injection. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and complications were observed and recorded. Results: The mean operation duration of the treatment group (42.06 ± 16.77 min) was significantly shorter than that of the control group (50.19 ± 21.61 min, p = 0.042). Only 1 case of the control group underwent a second surgery, and the final reattachment ratios of the 2 groups were both 100%. BCVA improved in both the treatment group (from 0.91 ± 0.79 to 0.42 ± 0.58 logMAR, p < 0.001) and the control group (from 0.82 ± 0.70 to 0.41 ± 0.37 logMAR, p = 0.001). The improvements of BCVA of the treatment group and control group were –0.49 ± 0.38 and –0.42 ± 0.46 logMAR, with no significant difference (p = 0.594). There was no significant difference in IOP and complications between the 2 groups. Conclusions: 25-gauge endo-illumination-aided SB combined with hyaluronate injection was safe and effective for RRD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endo-Illumination-Aided Scleral Buckling Combined with Intravitreal Injection of Hyaluronate for Treatment of Rhegmatogenous Retinal Detachment

Zhao¹,

Yan²,

You³

et al. 2020

Ophthalmologica

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“…Our study confirmed the advantages of the use of endoillumination and noncontact wide-angle viewing system which had been reported previously: (1)upright images of the fundus and better visualization for retinal details, (2)reducing the recurrence rate by sealing all retinal holes even those that were not identified preoperatively, (3)making scleral buckling an option for the cases with small pupils or opacity of refractive media, (4)shortened operation time, (5)enabling to obtain video record for further training and review, and finally, (6)eliminating surgeons' stress caused by bending neck and waist over and over again when using an indirect ophthalmoscope. Chandelier endoilluminators were also reported to be used combined with noncontact wide-angle viewing system [10]. But we believe that fiber illuminator might be a better choice because it could be aimed directly to the affected part to obtain a clearer sight view and Chandelier is more expensive and not so widely used as a routine surgical equipment.…”

Section: Discussionmentioning

confidence: 99%

Endoillumination aided scleral buckling combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment

Zhao

Wang

2019

Preprint

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Background: To evaluate the efficiency and safety of 25-gauge illumination aided scleral buckling surgery combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment Methods: This study was undertaken in a prospective, nonrandomized, and uncontrolled manner. Patients of rhegmatogenous retinal detachment were performed scleral buckling surgery with the aid of intraocular illumination and noncontact wide-angle viewing system. Hyaluronate was injected into the vitreous cavity to maintain intraocular pressure stable after subretinal fluid drainage through the external sclerotomy when necessary. Best corrected visual acuity(BCVA), intraocular pressure, fundus examination and complications were observed and recorded. Results: Twenty-eight consecutive patients (28 eyes) were enrolled. Subretinal fluid drainage and hyaluronate injection was performed in 12 eyes. The final reattachment ratio was 100%. BCVA increased after operation (P<0.001) and no significant difference was observed between preoperative and postoperative intraocular pressure (P=0.149). No iatrogenic retinal break, choroidal hemorrhage or endophthalmitis were observed. Conclusions: Endoillumination aided buckling surgery combined with intravitreal injection of hyaluronate could be an option for treatment of rhegmatogenous retinal detachment especially for the cases of highly elevated retina. Trial registration: ChiCTR1800020055. Retrospectively registered on December 12, 2018. Key words: Rhegmatogenous retinal detachment, scleral buckling, noncontact wide-angle viewing system, endoillumination, intravitreal injection of hyaluronate.

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“…Nam et al [11] reported a similar method soon. Hu et al [12] used 25-G endoillumination and a contact lens microscope in 2017. Caporossi et al [13] presented results of scleral buckling with a cannula-based 27-G chandelier endoilluminator in 2017.…”

Section: Introductionmentioning

confidence: 99%

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

Jeon

Han

2019

Ophthalmologica

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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.

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Outcomes of scleral buckling using chandelier endoillumination

Abstract: There was no complication found due to the chandelier insertion in early postoperative period. Chandelier endoillumination is a feasible method for retinal visualization under surgical microscope during scleral buckling.

Cited by 30 publications

References 19 publications

Endo-Illumination-Aided Scleral Buckling Combined with Intravitreal Injection of Hyaluronate for Treatment of Rhegmatogenous Retinal Detachment

Endo-Illumination-Aided Scleral Buckling Combined with Intravitreal Injection of Hyaluronate for Treatment of Rhegmatogenous Retinal Detachment

Endoillumination aided scleral buckling combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment

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

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