Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

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.

Figure 1

Examination result of case 10 before and after surgery. (a) Preoperative fundus photography showed retinal detachment and holes. (b–d) Fundus photography showed retinal reattachment, scleral buckle ridge, and cryoretinopexy scar at different times after surgery. (e) OCT demonstrated macular off and intraretinal cyst before surgery. (f–h) OCT showed macular reposition. (i) B-ultrasound confirmed retinal detachment. (j, k) B-ultrasound demonstrated retina reattachment and scleral buckle ridge. (l) 25-gauge chandelier insertion site was checked by UBM.