Abstract
Purpose :
Scleral buckling has been a successful technique for the repair of rhegmatogenous retinal detachments (RRD) but its popularity has declined with advances in vitrectomy surgery and wide field viewing systems. Chandelier endoillumination-assisted scleral buckling capitalizes on advancement in wide field viewing and may facilitate teaching by shared direct visualization. This study compares operative times and clinical outcomes of chandelier-assisted scleral buckles (CB) with traditional scleral buckles (SB) at an academic teaching center.
Methods :
Retrospective case-matched cohort study involving patients undergoing primary CB and surgeon-matched SB for RRDs at Wills Eye Hospital. Cases were matched 1:1 by attending surgeon with patients who underwent SB in the period immediately preceding the CB cases. Patients had complete ophthalmologic exams pre- and postoperatively. Paired t-tests and Levene’s Test for Equality of Variances were used to compare clinical outcomes and operative times. Patients who had intraoperative prophylactic laser retinopexy in the fellow eye were excluded from analysis of operative times.
Results :
17 eyes undergoing CB and 17 eyes undergoing SB for RRD were included. Baseline characteristics were similar between the CB and SB groups, including age (47±14 vs. 44±16 years), macula involvement (76% vs. 47%), and preoperative logMAR visual acuity (VA; 0.61±0.69 vs. 0.40±0.53). Mean follow-up was 5.74 months across the two groups. Single surgery success was similar between the two groups (82% CB vs. 88% SB, p= 0.25). LogMAR VA at postoperative months 1 (0.63±0.52 vs. 0.76±0.73), 3 (0.99±1.6 vs. 0.54±0.78), and at the last follow-up (0.65±0.70 vs. 0.43±0.54) between the CB and SB eyes were not statistically different. Operative times were slightly shorter in the CB eyes (69±10 min) compared to SB eyes (75±15 min), although this result was not statistically significant (p=0.31). No intraoperative complications or adverse events were noted.
Conclusions :
Eyes undergoing CB have similar clinical outcomes to traditional SB while being an equally efficient surgical technique at an academic teaching center. Future studies will be necessary to determine if CB may be more time efficient with a larger number of cases and greater experience with the technique.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.