SCLERAL SELF-INDENTATION DURING CHANDELIER-ASSISTED PERIPHERAL VITRECTOMY UNDER AIR FOR RHEGMATOGENOUS RETINAL DETACHMENT: A Retrospective Cohort Study

Evaluation of the (Baha) technique of scleral indentation using a self-retained scleral indenter during vitrectomy surgery: a randomized trial

AIMS

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.

METHODS

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.

RESULTS

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.

CONCLUSION

The (Baha) technique is effective and safe, especially in patients with a larger palpebral fissure.

Self-Made Sleeve for Chandelier Light Simulation

PURPOSE

To develop a quick and cost-effective alternative to a chandelier light for vitrectomy.

METHODS

The surgical material available in an ophthalmologic operating room was used to create a sleeve for the vitrectomy light probe and tested on 30 consecutive retinal detachment cases for feasibility.

RESULTS

A 64 × 5-mm cotton swab stick was cut into the length of the light probe minus the length of the trocar and subsequently pierced by a blunt needle. With this sleeve, the light probe could be safely handled similar to a chandelier light during surgery.

CONCLUSION

A sleeve for the light probe can serve as a substitute for a chandelier light during scleral depression in retinal detachment surgery.