Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Anaesthesia and Surgical Intensive Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Int Ophthalmol. 2024 Feb 17;44(1):92. doi: 10.1007/s10792-024-03028-6.
The current study compared a novel technique of scleral indentation using the self-retaining Leyla retractor to the conventional scleral self-indentation with the chandelier light.
Patients with rhegmatogenous retinal detachment were randomized on a 1:1 basis to either have the (Baha) indentation using a tip of a thimble scleral indenter welded to the support for the Leyla retractor system or to have the conventional scleral indentation while using a 25-gauge chandelier light. A video was recorded for the surgery of all the cases and reviewed by another consultant masked to the type of indentation. The indentation duration (i.e., the time in seconds between the first appearance of a hump due to scleral indentation in the recorded video until its final disappearance) was measured for every case.
The current study included 60 eyes of 60 adults with a mean age of 59.6 ± 9.8 years. Thirty-nine of the eyes were phakic and 21 were pseudophakic. The mean indentation time was 618 ± 87 and 696 ± 72 s in (Baha) indentation and conventional indentation groups, respectively. The difference was not statistically significant (p = 38). There was a positive correlation between the vertical palpebral fissure height and the indentation duration for both (Baha) indentation (r = 0.58) and conventional indentation groups (r = 0.42). Readjustment of the chandelier endo-illumination was required in 19 cases (63.3%) in the conventional indentation group. Iatrogenic breaks or accidental crystalline lens touch did not occur in any case.
The (Baha) technique is effective and safe, especially in patients with a larger palpebral fissure.
本研究比较了一种新的巩膜压迫技术，即使用 Leyla 牵开器进行巩膜自压迫，与使用 Chandelier 灯进行传统的巩膜压迫。
将患有孔源性视网膜脱离的患者随机分为两组，一组使用焊接在 Leyla 牵开器系统支撑上的 thimble 巩膜压迫器尖端进行（Baha）压迫，另一组使用 25G Chandelier 灯进行传统的巩膜压迫。对所有病例的手术过程进行录像，并由另一位对压迫类型不知情的顾问进行审查。测量每个病例的压迫持续时间（即，记录视频中由于巩膜压迫而首次出现驼峰到最后消失的时间，以秒为单位）。
本研究共纳入 60 例 60 只眼成年人，平均年龄为 59.6±9.8 岁。39 只眼为有晶状体眼，21 只为无晶状体眼。（Baha）压迫组和传统压迫组的平均压迫时间分别为 618±87 和 696±72 秒。差异无统计学意义（p=0.38）。（Baha）压迫组（r=0.58）和传统压迫组（r=0.42）的垂直睑裂高度与压迫持续时间呈正相关。在传统压迫组中，有 19 例（63.3%）需要重新调整 Chandelier 内照明。在任何情况下都没有发生医源性破裂或意外接触晶状体。
（Baha）技术是有效和安全的，特别是在睑裂较大的患者中。
