Chandelier-assisted segmental scleral buckling for rhegmatogenous retinal detachment repair

Abstract

Aim: To evaluate a modified technique for SB surgery using chandelier endoillumination and minimal segmental buckling through a small conjunctival incision in rhegmatogenous retinal detachment repair.Methods: A prospective interventional case study included 30 phakic eyes with primary RRD that was repaired by chandelier assisted SB using wide angle viewing (WAV) contact lens. Transconjunctival traction sutures were placed in four rectus muscles to avoid 360° conjunctival peritomy. A radial conjunctival opening was made between recti muscles over the break. Using pediatric speculum to retract the conjunctiva and Tenon’s capsule pre-placed 5-0 Dacron mattress suture was secured in the area planned for buckle placing after break marking and cryotherapy. A radial sponge of appropriate length and width was tightened with sutures in place. Anatomical and visual outcome at 6 months were the major outcome measures. Minor outcome measures included other postoperative complications.Results: The mean ± standard deviation BCVA was improved from 0.33±0.61 preoperatively to 0.13±0.36 logMAR units 6 months postoperatively. External subretinal fluid drainage was performed in 18 cases (60%). Air injection was required in 26 patients (87%). Paracentesis was performed in 11 cases (37%).The primary anatomical success of retinal reattachment was achieved in all cases. Three patients (10%) experienced epi-retinal membrane (ERM) formation after 3 months. No other surgical complications were detected during follow up period. Conclusion: In conclusion, SB using a cannula-based chandelier endo-illuminator is a modified new technique and is promising for the management of RRDs.