Procedure For Detachment Research Articles

Scleral imbrication with vitreoretinal surgery as a primary procedure for retinal detachment in pathological myopia.

A 45-year-old male presented with diminution of vision in the right eye (RE) for the past 2 weeks. He underwent sequential bilateral cataract surgery 25 years ago, with an intraocular lens in RE, which was his better eye. The left eye was aphakic with a thick fibrous membrane at the pupillary plane. Visual acuity was hand movement in the RE with the iris claw lens and total bullous retinal detachment (RD). The axial length with RD was 28.6 mm in RE and 29 mm in the left eye (LE). We did a vitrectomy with scleral imbrication, endolaser, fluid gas exchange, and tamponade in the RE. The LE developed RD subsequently, and he underwent similar surgical procedures in his LE. The best corrected visual acuity in his RE was 20/80, and that in the LE was 20/120 on follow-up. RD with staphyloma is a surgical challenge as the thin atrophic retina at the posterior pole fails to conform to the concavity of staphyloma. Vitrectomy with tamponade alone does not take care of staphyloma and has more chances of recurrent detachment or persistent fluid at the posterior pole. Scleral imbrication shallows the staphyloma cavity and shortens the axial length, thereby giving a good surgical outcome.

Giant Retinal Tear Detachment: Clinical presentation and Treatment Outcomes in 396 patients.

To study etiology, clinical presentation, anatomical and functional outcomes of patients with giant retinal tear detachment (GRTD) at a tertiary eye institute. Retrospective, consecutive case series of 396 patients (396 eyes) who underwent surgery were reviewed. Factors affecting the final anatomical and functional success were determined. Mean age was 37 years (range; 1-79 years) and 86% (n=339) of the subjects were male. Trauma (21%) and high myopia (11%) were predisposing risk factors. Two hundred and seventy-seven eyes (70%) had giant retinal tear configuration of >180o and <270o, associated with partial retinal detachment (RD) in 282 (71%) eyes and macular detachment in 262 (66%) eyes. Primary surgery included pars plana vitrectomy (PPV) (n=240, 61%), PPV with encirclage band (n=152, 38%) or scleral buckle (n=4, 1%). The mean follow-up duration was 15 months (median, 8.4 months; range, 3-83 months). Anatomical success after initial surgery was 64% (255 eyes), which improved to 78% (308 eyes) after undergoing a second vitreoretinal procedure for recurrent RD (53 eyes). Median visual acuity improved from 20/1500 preoperatively to 20/400 at final follow-up (p= 0.01), and 15% of eyes achieved postoperative visual acuity of 20/60 or better. Factors associated with poor anatomical success included age < 16 years (p=0.005), and presenting visual acuity 20/400 or less (p=0.001). Trauma and myopia constituted the major risk factors for GRTD in our series. Surgery for GRTD managed with PPV with or without encirclage band and silicone oil tamponade had good anatomic and favourable visual outcomes at last follow-up.

Evaluation of ocular pulse amplitude changes after the retinal detachment repair.

The study was conducted to determine the ocular pulse amplitude (OPA) changes, measured with a dynamic contour tonometer (DCT), after surgical retinal detachment repair. This was a prospective and comparative study. Thirty patients (30 eyes) who had undergone uncomplicated unilateral scleral buckling and encircling procedures for quadrant or half-retinal rhegmatogenous retinal detachment were referred for DCT one day before the surgery was performed, on the 1st, 7th, and 30th postoperative day. Methods of descriptive (arithmetical mean, standard deviation) and analytical statistics (analysis of variance) were used to analyze the data and evaluate the significance of the difference. A value of P less than 0.05 was considered statistically significant. The data were evaluated for normality with the single-sample Kolmogorov-Smirnov test. OPA values decreased significantly after scleral buckling procedures (p < 0.0001), but regained near to preoperative values one month after the surgery. OPA tends to decrease after retinal detachment surgery. Restoring patients' vision with scleral buckling and encircling procedures gives early changes in blood supply to the choroid and ocular nerve, and since OPA is an indirect parameter of choroidal vascularization, measuring these values can help make an insight into ocular hemodynamics.

Causes and Managements of Early-Onset Ocular Hypertension Following Pars Plana Vitrectomy with Silicone Oil for Retinal Detachment and Exploration of Trabeculectomy as a Viable Alternative Management: A Pilot Study.

This study aims to study a relatively unexplored topic about the causes and managements of early-onset ocular hypertension (OHTN) following the pars plana vitrectomy with silicone oil (PPV with SO) procedure for retinal detachment. Additionally, to explore the outcome of trabeculectomy in managing such patients. This is a retrospective exploratory pilot study. We studied 23 patients who underwent the procedure then subsequently developed ocular hypertension within a month of the procedure. The probable causes for their early-onset ocular hypertension were identified and addressed with medicine, peripheral iridotomy (PI), complete or partial silicone removal. Trabeculoplasty was done in irretractable causes. This study aimed to evaluate the causes of early onset ocular hypertension after pars plana vitrectomy with silicone oil and explore the outcome of different managements including trabeculectomy. Inflammation (n=11, 47.8%) was the most common cause of early-onset ocular hypertension. Other causes were overfilling/spilling of silicone oil in anterior chamber (n=5, 21.7%), pupillary block (n=4, 17.4%) and angle-recession glaucoma (n=2, 8.69%). Majority of the cases responded to intraocular pressure (IOP) lowering medications (n=11). Three eyes with persistently high intraocular pressure underwent trabeculectomy after which the intraocular pressure was controlled. Even though prior studies have reported that trabeculectomy does not address late-onset ocular hypertension, our study shows that the procedure might be helpful in early-onset ocular hypertension. This is probably because at the time of presentation for early-onset ocular hypertension, silicone has not emulsified, which will not be the case in late-onset ocular hypertension. If a large study also shows that trabeculectomy can correct early-onset ocular hypertension, this information can guide the practices of ophthalmologists whose patients cannot afford expensive glaucoma drainage devices.

Impact of COVID-19 lockdown on surgical procedures for retinal detachment in France: a national database study

Background/aimsThe COVID-19 crisis and the decisions made regarding population lockdown may have changed patient care. We aimed to investigate the incidence rate of rhegmatogenous retinal detachment (RRD) cases during the...

Incidence and Risk Factors for Intraocular Pressure Rise after the Scleral Buckle Surgery for Retinal Detachment.

Purpose:To determine the incidence and risk factors for intraocular pressure (IOP) rise after the scleral buckle (SB) procedure for retinal detachment (RD).Methods:A retrospective chart review of the medical records of patients, who underwent RD repair by SB performed by a single surgeon and had a minimum follow-up of 6 months was carried out. The outcome measures were the incidence of IOP rise in the operated eyes and the associated risk factors.Results:Fifty-two eyes of 52 patients with a median postsurgical follow-up of 18 months (interquartile range: 6, 36, range: 6–60 months) were included. Seven eyes had encircling buckle, 23 eyes had encircling buckle and 1 quadrant segmental buckle, and 22 eyes had encircling buckle and 2 quadrant segmental buckle. IOP rise was seen in 15/52 eyes (28.85%), within 1 month of the SB surgery. Nine out of 15 eyes (60%) of patients <40 years of age had a rise in IOP as compared to 6/37 eyes (16.2%) of patients >40 years of age (P = 0.002). Patients <40 years had a significant increased risk of developing IOP rise, compared to those above 40 years of age (adjusted odds ratio: 7.246 with 95% confidence interval of 1.641–31.986, P = 0.009). None of the fellow eyes had a rise in IOP during the follow-up period. None of the operated eyes with raised IOP progressed to glaucoma.Conclusions:Elevated IOP is a common complication after the SB procedure, and age <40 years is associated with a greater risk of development of increase in the IOP. Hence, IOP monitoring after the SB surgery is of paramount importance to detect early rise during follow-up.

A Multiple Evanescent White Dot Syndrome–like Reaction to Concurrent Retinal Insults

To describe a clinical picture resembling classic multiple evanescent white dot syndrome (MEWDS) potentially triggered by previous or concurrent, apparently unrelated, ocular events and to provide a literature review of similar presentations. Retrospective chart series and literature review. Consecutive patients diagnosed with MEWDS at the Feinberg School of Medicine, Northwestern University, Chicago, Illinois, and the IRCCS San Raffaele Scientific Institute, Milan, Italy, between July 2019 and June2020. Charts of patients were reviewed. Ophthalmic history, best-corrected visual acuity, spectral-domain OCT results, OCT angiography results, fundus autofluorescence results, ultra-widefield fluorescein angiography results, and indocyanine green angiography results were collected. A PubMed-based search was carried out for similar presentations using the terms MEWDS and white spot syndromes. An ocular history positive for previous or concurrent ocular events in patients with MEWDS was sought in our cohort and the existing literature. Five eyes of 4 patients (2 females; age range, 16-81 years) were included. The first eye had a history of bilateral Best vitelliform dystrophy and unilateral choroidal neovascularization. The second eye had angioid streaks complicated by choroidal neovascularization and underwent prior thermal laser photocoagulation. The third eye had a history of high myopia and a scleral buckle procedure for retinal detachment. The fourth patient had bilateral idiopathic retinochoroiditis. We identified 16 case reports from 5 previous publications that support a MEWDS-like reaction to previous ocular insults. We suggest a MEWDS-like reaction may be elicited by ocular events in a subset of susceptible patients. We hypothesize that damage to the outer retina may play a role in triggering the local inflammatory response.

Case Series of Urrets-Zavalia Syndrome After Descemet Membrane Endothelial Keratoplasty

To present a case series of Urrets-Zavalia syndrome (UZS) that developed after Descemet membrane endothelial keratoplasty (DMEK). A retrospective chart review was performed to identify patients who underwent DMEK by a single surgeon at the Duke Eye Center from 2017 to 2019 and subsequently developed UZS. Demographic data, preoperative history, operative notes, and postoperative course were reviewed. We describe 5 cases of UZS after DMEK (ages 19-74 years; 3 men and 2 women). Onset of UZS was noted at postoperative week 1 (n = 1), 2 (n =3), or 4 (n = 1). Four patients had an underlying diagnosis of Fuchs endothelial dystrophy and 1 had posterior polymorphous corneal dystrophy. Sixty percent (n = 3) of patients had an elevated intraocular pressure on postoperative day 0 or 1, and 40% (n = 2) of patients also had a pupillary block. One patient developed UZS after a rebubbling procedure for partial graft detachment and another developed UZS after repeat DMEK transplantation. Of the 3 patients who underwent bilateral combined DMEK and cataract surgery, 1 developed UZS in the second eye, whereas 2 developed UZS in the first eye. Most patients experienced monocular diplopia or had cosmetic concerns because of their mydriatic pupils. Two patients had spontaneous improvement in mydriasis. UZS after DMEK is rare, with only 2 cases in the literature: Holtmann et al and Isac et al. We present the largest case series of UZS after DMEK to date. Postoperative elevation in intraocular pressure is a common contributing factor. Evaluation of more patients may elucidate additional risk factors for this condition.

Scleral buckling with chandelier illumination system in rhegmatogenous retinal detachment surgery: a large case series

AIM: To evaluate advantages of chandelier illumination system during scleral buckling (SB) procedures for rhegmatogenous retinal detachment (RRD) surgery. METHODS: In this comparative, retrospective study, 72 eyes of 72 patients undergoing SB for RRD at Minerva Hospital (Santa Maria Capua Vetere, Italy), divided in 2 groups of 36 eyes each were collected. In one group (A) eyes underwent SB with chandelier, in the other one (B) eyes underwent SB without using chandelier illumination system. Every eye of both groups was checked before surgery and at 1, 3, 7, 14, 30, 90 and 180d follow up. Parameters such as additional procedures, best spectacles visual acuity (BSVA; measured with Snellen Lines as decimal fraction), surgical time and retinal breaks recurrences had been analyzed before and after surgery and statistical comparison have been run between two groups. RESULTS: A significant (P&lt;0.01) improvement in BSVA was observed at 6mo follow up in both groups; comparing groups A and B, no significant clinical differences was found in recurrences rate whereas mean surgical time in group A was statistically lower than the group B ones. CONCLUSION: According to results observed, even if they need to be confirmed in further studies with larger population, chandelier illumination system could be considered a valuable tool for SB surgery in eyes affected by RRD.

EFFECTIVITY OF PNEUMATIC RETINOPEXY PROCEDURE IN PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT (RRD

Aim : To evaluate the effectiveness of pneumatic retinopexy (PR) for repair of primary rhegmatogenous retinal detachment (RRD) with respect to single operation success (SOS) and best corrected visual acuity (BCVA).&#x0D; Method : This retrospective review comprised 8 eyes with primary rhegmatogenous retinal detachment with superior break that undergone pneumatic retinopexy as the initial procedure between 2009-2014 at Jakarta Eye Center, Indonesia.&#x0D; Result : The mean age of subjects was 49 ± 14.35 years. Four subjects (50%) had Single operation had only done success after 6 months of observation. The eyes that failed single procedure underwent vitrectomy and silicon oil tamponade. Subjects that only done single procedure had better BCVA (0.01 ± 1,3 logMAR) compare to subjects that done secondary procedure (0.3 ± 0.42 logMAR) after 6 months of observation.&#x0D; Conclusion : Pneumatic retinopexy is still an effective procedure for primary rhegmatogenous retinal detachment with superior breaks although in our study the single operation success was 50%.

Effective and Intact Cell Detachment from a Clinically Ubiquitous Culture Flask by Combining Ultrasonic Wave Exposure and Diluted Trypsin

Bioengineering research and applications are supported by cell culture technologies that produce a large number of homogeneous cells. However, trypsin used in the general culture procedure for cell detachment decreases cell activity and culture efficiency. Furthermore, manually conducted culture procedures, especially pipetting after trypsin treatment, can induce inhomogeneous mechanical stress in cells, which may influence cellular functions. Alternate detachment methods using specialized culture devices without trypsin and/or manual pipetting have been reported. However, conventional trypsinization is still widely used. Diluted trypsin increases culture efficiency. Therefore, we developed a cell-detaching method using diluted trypsin and ultrasonic vibration for cell detachment from ubiquitous culture vessels. To demonstrate our concept, we used a T25 flask. Vibration of the culture surface was excited by ultrasonic waves propagated from an ultrasonic transducer placed under the flask. Using the proposed method, cells were completely detached by diluted trypsin, whereas 8.6% of cells remained on the flask with manual pipetting. The viability and proliferation of cells detached by the proposed method were higher than those of cells detached by the conventional method, owing to the low concentration of trypsin. Furthermore, glucose consumption after detachment showed no abnormality, eliminating possible oncogenesis. Two membrane proteins were quantified immediately after detachment and at 24 h of culture, and there were no differences between the detachment methods. Thus, we conclude that our proposed method improves culture efficiency without any adverse effects and ensures homogeneous mechanical stress on cells.

Results of pars plana vitrectomy for primary rhegmatogenous retinal detachment with PVR grades A and B in high-myopic eyes

PurposeTo evaluate the results of pars plana vitrectomy (PPV) without adjuvant buckling procedures for the primary rhegmatogenous retinal detachment (RRD) with PVR grades A and B in high-myopic eyes.MethodsA retrospective review included 291 eyes treated for primary RRD from 2008 to 2016. The single surgery success rate (SSSR), the total number of surgeries, outcomes and complications were analysed between group of 67 eyes with high axial myopia (group A) and group of 224 eyes without high myopia (group B).ResultsThe mean follow-up was 30.6 ± 22.8 months. The SSSR in group A was 82.1% and in group B was 86.2% (p > 0.05). The final reattachment rate and number of required surgeries were in group A 96.3% (3.1 surgeries) and in group B 96.0% (2.8 surgeries). The initial BCVA improved in group A from 1.58 to 0.58 LogMAR at year 3; and in group B from 1.21 to 0.34 LogMAR. In match-pair analysis of macula-off RRD, no significant difference of the CRT between groups A and B was observed within 3 years of follow-up.ConclusionThe anatomical success of primary PPV for RRD did not differ between high-myopic and non-high-myopic eyes in PVR grades A and B. However, functional results of high-myopic eyes are worse compared to eyes without high axial myopia.

Strabismus surgery outcomes without removal of scleral buckle in patients with previous retinal detachment repair

To report the motor and sensory outcomes of strabismus surgery following scleral buckle procedure for retinal detachment (RD) without removal of the scleral buckle. The medical records of patients who underwent strabismus surgery without removal of scleral buckle following RD surgical repair at a tertiary referral center between 2002 and 2015 were reviewed retrospectively. Demographic data were recorded, and rates of surgical motor success (defined as horizontal deviation of ≤10Δ and vertical deviation of ≤4Δ) and sensory success (resolution of diplopia) were calculated. A total of 23 patients (mean age, 58.4±24.4years; 12 males) were included. The average time between the RD surgery and onset of strabismus was 11.05±10.95months (range, 1-42months). The strabismus was horizontal in 6 patients, vertical in 2, and combined in 15. Eighteen patients (78%) presented with diplopia. Adjustable sutures were used in 18 patients. Final motor surgical success was achieved in 17 of 23 patients (74%), and diplopia improved in 17 of 18 patients (94%) who had preoperative fusional capability. There was no statistically significant difference in age, number of RD surgeries, macular status, time to strabismus surgery, visual acuity in the worse eye, or magnitude of preoperative horizontal and vertical deviation with regard to motor success rate and with persistence of diplopia postoperatively. In our study cohort, strabismus surgery without removal of the scleral buckle resulted inmotor success and alleviated diplopia in the majority of patients with prior RD repair.

Preliminary results of extra-scleral and vitreoretinal procedures for rhegmatogenous retinal detachment

To date, the problem of rhegmatogenous retinal detachment (RD) relapses due to the proliferative vitreoretinopathy (PVR) progression remains unsolved, there is no single surgical treatment algorithm for retinal detachment, and even more so for its recurrence. The aim is to evaluate the structure of surgical care provided to patients with RD using extensive clinical material, taking into account different methods used, frequency of RD recurrences, frequency of reoperations. Materials and methods. The study was carried out in the vitreoretinal department of the Ophthalmological Center of the City Multifunctional Hospital No. 2 of St. Petersburg. 1502 cases of hospitalization for rhegmatogenous retinal detachment during 2015-2016 have been analyzed, results of surgical treatment have been assessed, number of relapses and frequency of reoperations have been established. Results. RD recurrence after surgical treatment occurs in 20.6% of patients, and vitrectomy is applied twice as often as extrascleral procedures. The use of endovitreal techniques is generally more effective than of extrascleral ones.

Pneumatic retinopexy outcomes as primary or secondary surgical option for treating rhegmatogenous retinal detachment

Purpose:To report the outcomes of pneumatic retinopexy (PR) performed as a primary surgical procedure for rhegmatogenous retinal detachment (RRD) or as a secondary procedure for recurrent RRD.Methods:We retrospectively analyzed case records of 54 patients (54 eyes) who underwent PR for RRD by injecting 0.3 ml of perfluoropropane (C3F8) in the vitreous cavity and cryopexy to break in the same sitting, followed by positioning.Results:A total 54 eyes of 54 patients aged between 17 and 84 years (mean - 51.3, median - 53 years) were included in the study. Except five eyes, all had breaks in the superior quadrants. The RRD ranged from 1 quadrant to 4 quadrants. Twenty-eight eyes (51.8%) were phakic and 26 (48.1%) were pseudophakic. The follow-up ranged from 6 to 144 months. In 25 eyes (46.2%), PR was the primary intervention and was successful in 15 (60%) eyes with a significant visual improvement (P = 0.023). Twenty-nine eyes (52.7%) with failed scleral buckle or failed pars plana vitrectomy underwent PR with a success rate of 65.5% and significant visual improvement (P = 0.0017). Progression of proliferative vitreoretinopathy changes (40%) was the most common cause of failure. The success rate was higher in phakic eyes, eyes with attached macula, superior breaks, superior RRD, and RRD limited to 3 quadrants or less.Conclusion:PR remains a minimally invasive procedure which can be used primarily or as a salvage procedure in failed surgery with moderately good success rate and minimal complications. One-step procedure reduces patient visits and ensures adequate treatment of the break.

Modified Hamilton’s Controlled Encircling Procedure for Retinal Detachment

Purpose: To describe a novel, simple, and reproducible encircling scleral buckle technique based on Hamilton’s controlled encircling procedure in order to standardize buckle height achievement in cases of retinal detachment. Methods: We describe a case series in which a novel modification of Hamilton’s surgical technique was used, consisting of a typical encircling buckling procedure anchored in the center of each quadrant, with the ends of the band passed through a Watzke sleeve. Reference marks were placed to allow measurable shortening of the band when its ends were pulled to create an encircling indent. Postoperative ultrawide field retinal images were analyzed. Results: Our simple technique yielded predictable and reproducible postoperative scleral buckle heights. Shortening of the silicon band by 3, 4, 5, and 6.25 mm produced shallow indents, while additional shortening was considered excessive. Conclusion: Published studies about scleral buckle as a primary procedure or a combined technique with vitrectomy lack a uniform surgical technique. Our modification of Hamilton’s technique uses objective measurements to generate a consistent and predictable postoperative buckle height.

Climate and the eye: Case-crossover analysis of retinal detachment after exposure to ambient heat

BackgroundRetinal detachment is an important cause of visual loss, but the association with outdoor heat exposure has not been studied. Our objective was to determine the relationship between acute exposure to high outdoor temperature and risk of retinal detachment. Materials and methodsWe analysed 14,302 individuals with inpatient procedures for retinal detachment from April through September between 2006 and 2013 in the province of Quebec, Canada. Using a time-stratified case-crossover study design, we examined the association of retinal detachment with outdoor summer temperature the preceding week. We estimated odds ratios (OR) and 95% confidence intervals (CI) for mean weekly temperature according to subtypes of retinal detachment (traction, serous, rhegmatogenous, breaks), and assessed associations by age and sex. ResultsExposure to elevated temperature the preceding week was associated with a higher likelihood of traction detachment, but not other forms of retinal detachment. Associations were stronger at <75 years of age in both men and women. Relative to 15°C, a mean weekly temperature of 25°C was associated with an OR for traction detachment of 2.71 (95% CI 1.56–4.71) before 55 years, 2.73 (95% CI 1.61–4.64) at 55–64 years, and 1.98 (95% CI 1.30–3.02) at 64–75 years. DiscussionElevated outdoor temperatures may be associated with an increased risk of traction retinal detachment. In light of climate change, a better understanding of the impact of heat waves on the eye and other sensory organs is needed.

Inverted internal limiting membrane flap technique as a useful procedure for macular hole-associated retinal detachment in highly myopic eyes

PurposeTo determine whether the inverted internal limiting membrane (ILM) flap technique contributes to high reattachment and closure rates in patients with macular hole-associated retinal detachment (MHRD).Patients and methodsIn all, 15 eyes of 15 patients with MHRD undergoing 25-gauge pars plana vitrectomy with the inverted ILM flap technique or ILM peeling. The patients were divided into the inverted ILM flap technique group (6 eyes) and ILM peeling group (9 eyes). The logarithm of minimal angle of resolution best-corrected visual acuity (BCVA) and retinal attachment and macular hole closure rates were compared between the two groups before and after surgery.ResultsNo significant differences were found in the pre- and postoperative BCVA at 1 and 3 months after surgery in either group (inverted ILM flap technique group, preoperatively 1.04±0.55, 1 month 0.95±0.30, 3 months 0.83±0.22; ILM peeling group, preoperatively 1.00±0.44, 1 month 1.05±0.38, 3 months 1.06±0.49; P>0.05, respectively). The postoperative BCVA at 6 months after surgery was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, 0.62±0.35; ILM peeling group, 1.02±0.41, P=0.045). The improvement in BCVA was significantly better in the inverted ILM flap technique group than in the ILM peeling group (inverted ILM flap technique group, –0.41±0.29; ILM peeling group, 0.02±0.36; P=0.021). The primary macular hole closure rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary reattachment rates were 100% in the inverted ILM flap technique group and 55.5% in the ILM peeling group. The primary macular hole closure and reattachment rates were not significantly different in both groups (P=0.056, respectively).ConclusionThe inverted ILM flap technique is a useful procedure for MHRD in highly myopic eyes.

The Effect of Scleral Buckling Surgery on Choroidal Thickness Measured by Enhanced Depth Optical Coherence Tomography: A Cross-Sectional Study.

IntroductionTo assess the anatomical changes taking place in the choroid after a scleral buckle (SB) procedure for retinal detachment repair.MethodsThis cross-sectional study looked at 23 adults with a history of unilateral retinal detachment repaired with a SB or other encircling element. The subjects underwent bilateral Enhanced Depth Spectral Domain Optical Coherence Tomography to image the choroid. The choroidal thickness (CT) was measured, and the non-operative eye was used as an internal control.ResultsCT was measured to be 170.8 ± 60.9 µm (mean ± SD) in eyes with SBs compared to 175.1 ± 61.9 µm in non-operative eyes. There was no statistically significant difference between the two groups (mean 4.3 µm, 95% CI −8.7, 17.3, p value 0.4973, paired t test).ConclusionPlacement of an SB as part of a surgery to repair retinal detachment did not significantly alter CT at the macula.

MODIFIED SCLERAL BUCKLING WITH A NON-CONTACT WIDE ANGLE VIEWING SYSTEM AND A 25G CHANDELIER ENDOILLUMINTOR

AbstractPurpose:To evaluate the outcome of scleral buckling surgery using a wide angle non-contact viewing system and chandelier endoillumination for per-operative fundus visualization in patients with non-complex rhegmatogenous retinal detachments.Materials and Methods:This was a prospective, interventional study carried out at the Department of Ophthalmology, Mayo Hospital Lahore over a period of six months. Non-probability convenience sampling technique was employed. Fifteen eyes of fifteen pati-ents underwent modified scleral buckling procedure for rhegmatogenous retinal detachment using a 25G Awh Chandelier (inserted into the sclera through the pars plana) and wide angle viewing system to view the fundus intraoperatively instead of the conventional Indirect Ophthalmoscope.Results:The mean age of the patients in this study group was 41.9 12.4 years. Out of fifteen patients, 13 had flat retinas postoperatively. Two patients had to undergo pars plana vitrectomy with silicone oil tamponade due to development of retinal detachment secon-dary to PVR.Conclusion:Modified scleral buckling with the con-current use of a chandelier light and wide angle viewing system provides an easier and more convenient means of visualizing the fundus under panoramic viewing conditions intraoperatively.Key Words:Wide angle viewing system. Retinal detachment. Scleral buckling. Endoillumination.