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

Abstract

Purpose: To describe a surgical variant for scleral buckling technique using a chandelier and scleral releasable suture.Methods: We collected retrospectively 20 eyes of 20 patients who underwent to scleral buckling for retinal detachment. In all cases, the surgeons performed the surgical variant of scleral buckling using a 27-gauge (G) chandelier as endoillumination and releasable 7.0 vicryl scleral suture.Results: None of the operated eyes developed lens opacity or lens marks at the entrance site of the chandelier used during the surgery, and no cataract development was observed as well, during the follow-up. Retinal reattachment was achieved in 19 out of 20 eyes at the first surgery in the follow-up time of 6 months. Conclusion:The association of chandelier and releasable suture was a useful surgical variant when performing scleral buckling technique for retinal detachment. Complications like lens opacity or lens marks at the entrance site of the chandelier due to the use of chandelier itself can be greatly reduced, as well as complications due to vitreous prolapse from the sclerotomy by using releasable scleral suture.

A Modified Suturing Technique to Produce Temporary Scleral Buckling Effect for Noncomplex Rhegmatogenous Retinal Detachment

“…[6][7][8][9] To decrease the incidence of complications and surgical difficulty, some modifications have been made in recent years, such as the use of absorbable sutures to tighten bands and wide-angle systems to check retinal breaks and ridges formed by the implants. 10,11 However, there are few reports with detailed descriptions of how to have releasable SB with absorbable sutures based on conventional surgical steps. The current article introduces a modified SB technique using a combination of nonabsorbable and absorbable sutures to fix and tighten silicone elements to produce a temporary buckling effect for noncomplex RRD and to investigate the tendency of refractive changes caused by this technique.…”

“…6–9 To decrease the incidence of complications and surgical difficulty, some modifications have been made in recent years, such as the use of absorbable sutures to tighten bands and wide-angle systems to check retinal breaks and ridges formed by the implants. 10,11…”

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.…”

Vitreous function and intervention of it with vitrectomy and other modalities

“…Hence, we have emphasized the importance of recognizing the functions of the vitreous body and increasing the popularity of SB for treating suitable primary RRD, as well as advised caution in the use of more aggressive surgery such as PPV. Besides that, the traditional SB is also improved by several modifications, which reduce complications and surgical difficulty, and shorten the operation time, increases the popularity of SB for treating primary RRD and maintain SB as an option for appropriate patients in the future [10][11] . It is time to recognize the functions of the vitreous, and the necessity for following strict surgical indications and careful assessment for vitrectomy procedures.…”