Scleral Buckling: A Look at the Past, Present and Future in View of Recent Findings on the Importance of Photoreceptor Re-Alignment Following Retinal Re-Attachment

Figures & data

Table 1 Comparative Outcomes of Chandelier Assisted Scleral Buckle and Conventional Scleral Buckle

Study Country	Conventional Scleral Buckling						Chandelier Assisted Scleral Buckling
	N	Pre-Op Mean VA (logMAR)	Post-Op Mean VA (logMAR)	Mean Surgical Time (min)	Single Surgery Success Rate	Complications	N	Pre-Op Mean VA (logMAR)	Post-Op Mean VA (logMAR)	Mean Surgical Time (min)	Single Surgery Success Rate	Complications
Tomita et al^Citation61 (2015) Japan	23	0.11	−0.01	130	95.7%	Intraoperative retinal herniation (4.3%), intraoperative corneal epithelial edema (21.7%), Postoperative corneal epithelial disorder (30.4%), macular edema (4.3%), cataract (4.3%), central serous chorio-retinopathy (4.3%)	16	0.1	−0.04	107	93.8%	Macular pucker (6.2%), corneal epithelial edema (6.2%)
Li et al^Citation64 (2016) China	47	0.42	Month 1 0.40 Month 3 0.29 Month 6 0.18 Month 12 0.13	Segmental buckling 83.15 Encircling buckling 114.2	92.4%	Elevated IOP (27.7%), macular pucker (2.1%)	47	0.43	Month 1 0.35 Month 3 0.28 Month 6 0.18 Month 12 0.12	Segmental buckling 62.5 Encircling buckling 95.6	94.3%	Elevated IOP (21.3%)
Narayanan et al^Citation58 (2016) India	14	1.20	0.90	95.7	85.7	Elevated IOP (7.1%), PVR (7.1%)	14	0.90	0.60	77.8	92.8	Elevated IOP (7.1%), intraoperative sclerotomy leak at the chandelier insertion site (21.4%)
Cohen et al^Citation62 (2019) Israel	27	0.60	Month 1 0.79 Month 3 0.52 Month 6 0.37	Not Reported	85.2	Cataract (9%)	22	0.48	Month 1 0.59 Month 3 0.34 Month 6 0.24	Not Reported	81.8	Cataract (9%)
Zhao et al^Citation65 (2019) China	20	0.82	0.41	50.2	95%	Elevated IOP (35%), Vitreous hemorrhage (5%)	25	0.91	0.42	42.1	100%	Elevated IOP (40%) Subretinal hemorrhage (4%)
Albalkini et al^Citation66 (2022) Egypt	26	1.15	0.50	120.3	80.8%	Accidental perforation during suturing (7.7%), Vortex vein injury (3.8%), ERM (3.8%), Cataract (3.8%)	23	1.32	0.67	102.5	78.3%	Vortex vein injury with vitreous incarceration after draining subretinal fluid (4.3%), Vitreous prolapse at the sclerotomy site (47.8%), ERM (34.8%)
Roca et al^Citation53 (2020) Latin America							282	1.21	0.76	Not Reported	85.1%	Scleral laceration (0.3%), choroidal hemorrhage (0.3%), ERM (1%), macular fold (0.3%), buckle exposure (1.4%)
Hu et al^Citation54 (2017) China							61	Not Reported	Not Reported	Not Reported	93.4%	Subretinal hemorrhage (3.3%)
Imai et al^Citation55 (2015) Japan							79	0.31	0.10	100.3	92.4%	Choroidal hemorrhage (6.3%), retinal break (1.3%), Lens touch (1.3%), glaucoma (1.3%), cataract (1.3%)
Jeon et al^Citation56 (2019) South Korea							29	0.38	0.19	Not Reported	93.1%	None
Kita et al^Citation57 (2019) Japan							18	0.17	0.07	Not Reported	100%	Diplopia (5.6%)
Nossair et al^Citation59 (2019) Egypt							21	1.28	0.7		90.5%	Vitreous prolapse (19%), sub retinal hemorrhage (4.8%), ERM (4.8%), diplopia (4.8%), Choroidal detachment (4.8%), elevated IOP (9.5%)
Seider et al^Citation60 (2016) USA							12	0.22	0.15	118	83.3%	None
Caporossi et al^Citation63 (2019) Italy							28	0.8	0.22	Not Reported	96.4%	None
La Spina et al^Citation68 (2021) Italy							107	Not Reported	Not Reported	41	94%	None

Abbreviations: VA, visual acuity; logMAR, logarithm of the minimal angle of resolution; IOP, intraocular pressure; ERM, epiretinal membrane; PVR, proliferative vitreoretinopathy.

Tomita Y, Kurihara T, Uchida A, et al. Wide-angle viewing system versus conventional indirect ophthalmoscopy for scleral buckling. Sci Rep. 2015;5(1):13256. doi:10.1038/srep13256

 PubMed Web of Science ®Google Scholar

Li XJ, Yang XP, Lyu XB. Comparison of scleral buckling using wide-angle viewing systems and indirect ophthalmoscope for rhegmatogenous retinal detachment. Int J Ophthalmol. 2016;9(9):1310–1314. doi:10.18240/ijo.2016.09.13

 PubMed Web of Science ®Google Scholar

Narayanan R, Tyagi M, Hussein A, et al. Scleral buckling with wide-angled endoillumination as a surgical educational tool. Retina. 2016;36(4):830–833. doi:10.1097/IAE.0000000000000792

 PubMed Web of Science ®Google Scholar

Cohen E, Rosenblatt A, Bornstein S, et al. Wide-angled endoillumination vs traditional scleral buckling surgery for retinal detachment - a comparative study. Clin Ophthalmol. 2019;13:287–293. doi:10.2147/OPTH.S182751

 PubMed Web of Science ®Google Scholar

Zhao T, Yan Y, Chen Y, et al. Endo-illumination-aided scleral buckling combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment. Ophthalmologica. 2020;243(4):316–322. doi:10.1159/000504714

 PubMed Web of Science ®Google Scholar

Albalkini AS, Abdullatif AM, Albalkini MS, et al. Chandelier-assisted versus standard scleral buckling for primary rhegmatogenous retinal detachment: a randomized clinical study. Retina. 2022. doi:10.1097/IAE.0000000000003519

 PubMed Web of Science ®Google Scholar

Roca JA, Maia M, da Cruz NFS, et al. Non-contact wide-angled visualization with chandelier-assisted scleral buckling for primary uncomplicated rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 2020;258(9):1857–1861. doi:10.1007/s00417-020-04737-1

 PubMed Web of Science ®Google Scholar

Hu Y, Si S, Xu K, et al. Outcomes of scleral buckling using chandelier endoillumination. Acta Ophthalmol. 2017;95(6):591–594. doi:10.1111/aos.13326

 PubMed Web of Science ®Google Scholar

Imai H, Tagami M, Azumi A. Scleral buckling for primary rhegmatogenous retinal detachment using noncontact wide-angle viewing system with a cannula-based 25 G chandelier endoilluminator. Clin Ophthalmol. 2015;9:2103–2107. doi:10.2147/OPTH.S91339

 PubMed Web of Science ®Google Scholar

Jeon GS, Han JR. Effectiveness of scleral buckling with a wide-field surgical microscope and chandelier illumination in retinal detachment repair. Ophthalmologica. 2019;242(1):31–37. doi:10.1159/000496165

 PubMed Web of Science ®Google Scholar

Kita M, Kusaka M, Yamada H, Hama S. Updated chandelier illumination-assisted scleral buckling using 3D visualization system. Clin Ophthalmol. 2019;13:1743–1748. doi:10.2147/OPTH.S218975

 PubMed Web of Science ®Google Scholar

Nossair AA, Ewais WA, Eissa SA. Chandelier-assisted scleral buckling using wide angle viewing contact lens for pseudophakic retinal detachment repair. Int J Ophthalmol. 2019;12(4):627–633. doi:10.18240/ijo.2019.04.17

 PubMed Web of Science ®Google Scholar

Seider MI, Nomides RE, Hahn P, et al. Scleral buckling with chandelier illumination. J Ophthalmic Vis Res. 2016;11(3):304–309. doi:10.4103/2008-322X.188402

 PubMedGoogle Scholar

Caporossi T, Finocchio L, Barca F, et al. Scleral buckling for primary rhegmatogenous retinal detachment using a noncontact wide-angle viewing system with a cannula-based 27-G Chandelier endoilluminator. Retina. 2019;39(Suppl 1):S144–S50. doi:10.1097/IAE.0000000000001891

 PubMed Web of Science ®Google Scholar

La Spina C, Del Turco C, Bogetto C, et al. Wide-angle 3D viewing system with valved trocar applied to chandelier-assisted scleral buckling. Eur J Ophthalmol. 2021;31(2):804–806. doi:10.1177/1120672120945091

 PubMed Web of Science ®Google Scholar