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Zhu D, Wong A, Jiao G, Zhang C, Yakobashvili D, Zhu E, Tham T, Lieberman R. Outcomes of Chandelier-Assisted Scleral Buckling in Rhegmatogenous Retinal Detachments: Systematic Review and Meta-analysis. JOURNAL OF VITREORETINAL DISEASES 2024; 8:158-167. [PMID: 38465358 PMCID: PMC10924592 DOI: 10.1177/24741264231224956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Purpose: 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. Methods: 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. Results: 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; P = .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; P = .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; P = .89). No cases of endophthalmitis were reported. Conclusions: 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.
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Affiliation(s)
- Daniel Zhu
- Department of Ophthalmology, Northwell Health Eye Institute, Great Neck, NY, USA
| | - Amanda Wong
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - George Jiao
- Department of Ophthalmology, Northwell Health Eye Institute, Great Neck, NY, USA
| | - Charles Zhang
- Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biomedical Sciences, State University of New York, University at Buffalo, Buffalo, NY USA
| | - Daniela Yakobashvili
- Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Edward Zhu
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Tristan Tham
- Department of Otolaryngology–Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Ronni Lieberman
- Department of Ophthalmology, Icahn School of Medicine, Mount Sinai Medical Center, and New York City Health and Hospitals, New York, NY, USA
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Chandelier-Assisted versus Standard Scleral Buckling for Primary Rhegmatogenous Retinal Detachment: A Randomized Clinical Study. Retina 2022; 42:1745-1755. [PMID: 35507948 DOI: 10.1097/iae.0000000000003519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare anatomical outcomes, functional outcomes, and rate of complications of standard (SSB) versus chandelier-assisted scleral buckling (CSB) in phakic eyes with rhegmatogenous retinal detachment (RRD). Methods: Patients were randomly assigned to either SSB or CSB. Surgical success/failure rate, corrected distance visual acuity (CDVA), surgical operating time, rate of intraoperative and postoperative complications including epiretinal membranes (ERM) by spectral-domain optical coherence tomography (SD-OCT) were compared between groups. Results: A total of 50 eyes of 49 patients were included. At 6 months, there was no statistically significant difference between groups in primary success, or final anatomical success (P > 0.9); mean CDVA at any visit (P values >0.05); or mean surgical time: 120.3±39.05 and 102.48±43.76 minutes for the SSB and CSB, respectively (P = 0.1). The CSB had a higher rate of postoperative complications (34.8%) compared to the SSB (3.8%) (P < 0.05). On SD-OCT, CSB had a statistically significant higher rate of ERMs compared to SSB (44% versus 18% (P < 0.05)) and showed vitreous entrapment in the chandelier sclerotomy site on the UBM. Conclusion: CSB do not offer encouraging advantages over SSB. On the contrary, we detected a higher rate of complications with CSB especially ERMs development.
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