Abstract
Objectives To report the long-term results of scleral buckling using 25-gauge chandelier illumination. Methods The medical records of all patients presenting to Shanghai Tenth People's Hospital with simple rhegmatogenous retinal detachment (RRD) from June 2013 to Oct 2015 were retrospectively reviewed in this consecutive case series. All patients underwent preoperative and postoperative best corrected visual acuity (BCVA), B-ultrasound, fundus photography, and optical coherence tomography examination. Ultrasound biomicroscopy (UBM) was obtained postoperatively. Results Ten patients (10 eyes) were included in the final analysis. Of 10 patients, the average age was 49.3 ± 18.9 years old, the average duration of RRD was 30.9 ± 53.3 days, and the mean follow-up period was 6.2 ± 0.9 years. There were nine eyes with myopia and four eyes with macular detachment. The primary anatomical success rate was 90%. Five eyes underwent 360-degree band with element surgery, and five eyes underwent element surgery alone. The average length of encircling band and element was 68.2 ± 1.3 mm and 10.5 ± 2.5 mm, respectively. There were no intraoperative or postoperative complications that occurred. The final BCVA was greater than or equal to 20/40 in nine eyes, of which four eyes achieved 20/20. UBM examination of the 25-gauge chandelier insertion site revealed no tissue proliferation. Conclusions For simple rhegmatogenous retinal detachment treatment, 25-gauge chandelier illumination-assisted scleral buckling is a kind of effective and safe method.
Highlights
Rhegmatogenous retinal detachment (RRD) leads to anatomical abnormality of the retina and, visual function impairment
We aim to describe six-year results of 25-gauge chandelier endoillumination and noncontact wide-angle viewing system-assisted scleral buckling surgery
A systematic review reported that scleral buckling provided superior postoperative outcomes than pars plana vitrectomy (PPV) on primary RRD [9]
Summary
Rhegmatogenous retinal detachment (RRD) leads to anatomical abnormality of the retina and, visual function impairment. Scleral buckling, which was first introduced in the 1950s [1], is a classic surgery to treat RRD. Conventional scleral buckling using indirect ophthalmoscope has some limitations, such as inverted image, limited surgical view, and surgical procedure cannot be shared and recorded [3]. Surgeons have made a lot of efforts like applying noncontact wide-angle viewing system, chandelier endoillumination [4], and 3D visualization system [5] to overcome the drawbacks of conventional scleral buckling. Scleral buckling under the microscope with chandelier endoillumination and noncontact wild-angle view system may reduce the chance of missing retinal breaks, make the peripheral retinal breaks or lesions more be identified and treated, and permit less extensive cryotherapy because of the improvement of illumination. Surgeons may feel more comfortable under the microscope than using indirect ophthalmoscopy
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