Abstract
ObjectiveAccurate scleral marking of retinal breaks is essential for successful scleral buckling. This study aimed to investigate the use of wide-field fundus images obtained with an Optos for preoperative estimation of the distance from the limbus to the retinal breaks.Methods and analysisThis is a retrospective review of 29 eyes from 26 patients with rhegmatogenous retinal detachment who received scleral buckling with anatomically successful repair. They underwent wide-field fundus photography with Optos California. In the pre- and postoperative fundus images, we measured distances from the macula to the retinal tears (TM), to the center of the vortex veins (VM), to the optic disc (DM), and to the posterior edge of the scleral buckle (BM).Results(BM—VM) / DM was significantly correlated with the distance from the limbus to the posterior edge of the scleral buckle that had been determined intraoperatively. (r = 0.705; p<0.001) We applied a regression line derived from this correlation with the value of (TM -VM) / DM in order to calculate estimated distances between retinal breaks and the limbus. The calculated distances were all within the range of distances from the limbus to the anterior and posterior edges of the scleral buckles.ConclusionPreoperative analysis of Optos images may be useful for estimating the distance from the limbus to retinal breaks, which might aid scleral marking during scleral buckling surgery.
Highlights
Recent advances in vitrectomy instrumentation and techniques have expanded its application to the repair of rhegmatogenous retinal detachment (RRD)
Preoperative analysis of Optos images may be useful for estimating the distance from the limbus to retinal breaks, which might aid scleral marking during scleral buckling surgery
Scleral buckling is still preferred in particular cases, such as those with RRD caused by breaks in lattice degeneration without posterior vitreous detachment
Summary
Recent advances in vitrectomy instrumentation and techniques have expanded its application to the repair of rhegmatogenous retinal detachment (RRD). Scleral buckling is still preferred in particular cases, such as those with RRD caused by breaks in lattice degeneration without posterior vitreous detachment. [1,2,3,4,5,6,7,8,9,10,11,12,13] This WAVS-assisted scleral buckling has advantages over the conventional indirect ophthalmoscopy-guided technique in observing retinal tears and the subsequent scleral marking. A very recent case report has raised a potential concern regarding infectious endophthalmitis development with the use of a chandelier endoilluminator during scleral buckling. The conventional indirect ophthalmoscopy-guided technique requires considerable surgical skill, mastery of the skill is still important for clinicians since its long-term safety has been proven with low incidence of endophthalmitis after conventional scleral buckling. The conventional indirect ophthalmoscopy-guided technique requires considerable surgical skill, mastery of the skill is still important for clinicians since its long-term safety has been proven with low incidence of endophthalmitis after conventional scleral buckling. [14]
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