Zhu Daniel, Wong Amanda, Jiao George, Zhang Charles, Yakobashvili Daniela, Zhu Edward, Tham Tristan, Lieberman Ronni
Department of Ophthalmology, Northwell Health Eye Institute, Great Neck, NY, USA.
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
J Vitreoretin Dis. 2024 Jan 19;8(2):158-167. doi: 10.1177/24741264231224956. eCollection 2024 Mar-Apr.
To examine the outcomes of chandelier endoillumination-assisted scleral buckling (chandelier scleral buckling) for rhegmatogenous retinal detachments (RRDs) and compare them with those of standard scleral buckling using indirect ophthalmoscopy. A literature search was performed on April 15, 2023. Outcomes analyzed included the primary anatomic success rates, surgical duration, and complication rates. A meta-analysis of proportions estimated the pooled success rate of chandelier scleral buckling. In addition, meta-analyses compared the success rates between pseudophakic eyes and phakic eyes having chandelier scleral buckling and compared success rates and surgical duration between standard scleral buckling and chandelier scleral buckling. Thirty studies with 1133 eyes were included. The pooled primary anatomic success rate of chandelier scleral buckling was 91.7% (95% CI, 89.6%-93.6%). In studies comparing success rates between the 2 techniques, there was no significant difference (risk ratio, 1.01; 95% CI, 0.94-1.08; = .80). The surgical times were significantly shorter with chandelier scleral buckling than with standard scleral buckling (mean difference, -18.83; 95% CI, -30.88 to -6.79; = .002). There was no significant difference in the success rate between pseudophakic eyes and phakic eyes (risk ratio, 0.99; 95% CI, 0.91-1.08; = .89). No cases of endophthalmitis were reported. Chandelier endoillumination-assisted scleral buckling may be a promising technique given its high rate of primary anatomic success for RRDs and success rates similar to those of standard scleral buckling. There was no significant difference in the efficacy of chandelier scleral buckling between pseudophakic eyes and phakic eyes.
为研究吊灯式眼内照明辅助巩膜扣带术（吊灯式巩膜扣带术）治疗孔源性视网膜脱离（RRD）的效果，并将其与使用间接检眼镜的标准巩膜扣带术的效果进行比较。于2023年4月15日进行了文献检索。分析的结果包括主要解剖成功率、手术时间和并发症发生率。对比例进行的荟萃分析估计了吊灯式巩膜扣带术的合并成功率。此外，荟萃分析比较了接受吊灯式巩膜扣带术的人工晶状体眼和有晶状体眼之间的成功率，并比较了标准巩膜扣带术和吊灯式巩膜扣带术之间的成功率及手术时间。纳入了30项研究共1133只眼。吊灯式巩膜扣带术的合并主要解剖成功率为91.7%（95%CI，89.6%-93.6%）。在比较两种技术成功率的研究中，无显著差异（风险比，1.01；95%CI，0.94-1.08；P = 0.80）。吊灯式巩膜扣带术的手术时间显著短于标准巩膜扣带术（平均差值，-18.83；95%CI，-30.88至-6.79；P = 0.002）。人工晶状体眼和有晶状体眼之间的成功率无显著差异（风险比，0.99；95%CI，0.91-1.08；P = 0.89）。未报告眼内炎病例。鉴于吊灯式眼内照明辅助巩膜扣带术治疗RRD的主要解剖成功率高且成功率与标准巩膜扣带术相似，其可能是一种有前景的技术。吊灯式巩膜扣带术在人工晶状体眼和有晶状体眼中的疗效无显著差异。
