A Comparative Study of Traditional Scleral Buckling to a New Technique: Guarded Light Pipe with Heads-Up Three-Dimensional Visualization.

Autor: Baldwin G; Retina Service, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA., Sokol JT; Retina Service, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA., Ludwig CA; Retina Service, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA., Miller JB; Retina Service, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Clinical ophthalmology (Auckland, N.Z.) [Clin Ophthalmol] 2022 Sep 19; Vol. 16, pp. 3079-3088. Date of Electronic Publication: 2022 Sep 19 (Print Publication: 2022).
DOI: 10.2147/OPTH.S378179
Abstrakt: Purpose: The guarded light pipe is a recently described alternative endoillumination technique to chandelier illumination. We sought to compare the outcomes of scleral buckling (SB) under indirect ophthalmoscopy (ID) to heads-up three-dimensional visualization with a guarded light pipe (3DGLP).
Methods: A retrospective comparative study was performed, including 47 eyes that underwent SB for rhegmatogenous retinal detachment (RRD) repair with either traditional ID (n = 31) or 3DGLP (n = 16).
Results: The single surgery anatomic success rate was 87.0% in the ID group and 87.5% in the 3DGLP group. The final anatomic success rate was 100% in both groups. The median (interquartile range) post-operative logMAR was 0.10 (0.0-0.20) in the ID group and 0.08 (0.02-0.69) in the 3DGLP group (p = 0.51). The median operative time was 107 (94-123) minutes in the ID group and 100 (90-111) minutes in the 3DGLP group (p = 0.25). Among eyes that underwent subretinal fluid drainage, the operative time was significantly longer in the ID group compared to the 3DGLP group, 113 (100-135) minutes vs 93 (85-111) minutes (p = 0.035). There were no post-operative complications in the ID group and one complication of self-resolving vitreous hemorrhage associated with a malfunctioning cryoprobe in the 3DGLP group (p = 0.34). There were no cases of post-operative cataract progression in either group.
Conclusion: Compared to traditional SB, 3DGLP improves ergonomics and educational value with similar anatomical, visual, intra and post-operative outcomes and may result in shorter operative time in cases requiring subretinal fluid drainage.
Competing Interests: J.B.M. is a consultant for Alcon, Allergan, Carl Zeiss, Sunovion, Topcon, and Genentech. The authors report no other conflicts of interest in this work.
(© 2022 Baldwin et al.)
Databáze: MEDLINE
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