AlAkeely Adel Gady, Alageely Abdulaziz, Alageely Omar
Retina Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Am J Ophthalmol Case Rep. 2020 Aug 29;20:100900. doi: 10.1016/j.ajoc.2020.100900. eCollection 2020 Dec.
This study aims to describe chandelier assisted scleral buckle (CSB) using 3D visualizing system in phakic uncomplicated Rhegmatogenous Retinal Detachment (RRD).
This technique was performed in 6 eyes of 6 patients with primary rhegmatogenous RD who underwent encircling circumferential scleral buckling with scleral tunnels. Heads up display 3D system was used for visualization and localization of the breaks, and Chandelier Endoillumination was used as a light source was inserted through a 27 G needle sclerotomy 3.5mm from the limbus. A partial-thickness scleral "belt-loop" tunnels in the four quadrants were created using crescent knife angle beveled (2.3 mm in width) to facilitate the smooth passage of the band a 240-silicone band as encircling circumferential buckle. Cryopexy was performed and the incision was closed with cautery or absorbable sutures.
Primary attachment success of 5 out of 6 and overall success was 100%. No intraoperative or postoperative complications observed although fellows in training performed half the procedures.
Heads up Sutureless Chandelier assisted Scleral Buckle can achieve excellent anatomical success while improving ergonomics and training. Furthermore, it is a safe procedure with less risk of complications and retinal phototoxicity.
本研究旨在描述在无晶状体单纯孔源性视网膜脱离（RRD）中使用3D可视化系统的吊灯辅助巩膜扣带术（CSB）。
对6例原发性孔源性视网膜脱离患者的6只眼进行该技术，这些患者接受了带巩膜隧道的环周巩膜扣带术。使用抬头显示3D系统对裂孔进行可视化和定位，并使用吊灯内照明，通过距角膜缘3.5mm处的27G针巩膜切开术插入光源。使用新月形斜角刀（宽度2.3mm）在四个象限制作部分厚度的巩膜“带袢”隧道，以利于240硅酮带作为环周扣带顺利通过。进行冷冻治疗，切口用烧灼或可吸收缝线闭合。
6只眼中5只眼一次复位成功，总体成功率为100%。尽管一半的手术由进修医生完成，但未观察到术中或术后并发症。
抬头式无缝线吊灯辅助巩膜扣带术在提高人体工程学和培训效果的同时，可取得优异的解剖学成功。此外，它是一种安全的手术，并发症和视网膜光毒性风险较低。
