Assessment of chandelier-assisted scleral buckling surgery

Abstract

Context Recently, there has been a shift towards the use of pars plana vitrectomy (PPV) as the first choice for rhegmatogenous retinal detachment (RRD) repair. Combining the excellent view of PPV using the noncontact viewing system and the 25 G chandelier endoillumination system in scleral buckling may make the procedure more convenient than the typical procedure using indirect ophthalmoscope. Aim The aim of the present study was to assess the safety and efficacy of the 25 G chandelier endoillumination system in scleral buckling surgery in primary RRD. Design The present study was designed as a prospective interventional case series. Setting This study was conducted as a private practice. Materials and methods The study included 20 eyes with recent RRD operated by scleral buckling using the chandelier endoillumination and noncontact viewing system of PPV. Statistical analysis was performed. Results In total, 20 eyes with recent primary RRD were operated using 25 G chandelier endoillumination-assisted scleral buckling. At first postoperative day, 18 eyes (90%) had totally attached retina and the remaining two eyes (10%) had minimal subretinal fluid, which was completely absorbed within 1 week. At 1 month, one eye had recurrent retinal detachment due to lower proliferative vitreoretinopathy, which was treated with PPV. The remaining 18 eyes had attached retina by 1, 3, and 6 months postoperatively. Best corrected visual acuity improved from 0.001-0.4 preoperatively to 0.02-0.8 3 months and to 0.05-0.8 6 months postoperatively. The crystalline lens remained clear at 6 months postoperatively for all 18 eyes (excluding an aphakic eye and a vitrectomized eye). Conclusion Using 25 G chandelier endoillumination, surgical microscope, and wide-angle noncontact viewing system of PPV in scleral buckling surgery is easier and more convenient than the original buckling procedure using an indirect ophthalmoscope.