CHANDELIER-ASSISTED VERSUS STANDARD SCLERAL BUCKLING FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT A Randomized Clinical Study

摘要

Purpose: To compare anatomical outcomes, functional outcomes, and rate of complications of standard scleral buckling (SSB) versus chandelier-assisted scleral buckling (CSB) in phakic eyes with rhegmatogenous retinal detachment. Methods: Patients were randomly assigned to either SSB or CSB. Surgical success/failure rate, corrected distance visual acuity, surgical operating time, and rate of intraoperative and postoperative complications including epiretinal membranes by spectral domain optical coherence tomography 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 corrected distance visual acuity 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 with the SSB (3.8) (P < 0.05). On spectral domain optical coherence tomography, CSB had a statistically significant higher rate of epiretinal membranes compared with SSB (44 vs. 19 P < 0.05) and showed vitreous entrapment in the chandelier sclerotomy site on the ultrasonic biomicroscopy. Conclusion: Chandelier-assisted scleral buckling surgery does not offer encouraging advantages over SSB. On the contrary, we detected a higher rate of complications with CSB especially epiretinal membranes development.