Scleral buckling technique using a 25-gauge chandelier endoilluminator

摘要

Scleral buckling is a basic surgical procedure for repairing a retinal detachment. The general procedure of scleral buckling is as follows: while observing the fundus, the retinal break is marked on the sclera and chorioretinal adhesion by cryopexy or subretinal fluid drainage may be performed as necessary, with subsequent positioning and suturing of the buckling material to the sclera.The fundus should be observed during the buckling procedure to exactly identify retinal breaks and to determine the adequacy of the height and position of the buckle material. Proper illumination is necessary for fundus observation. Traditionally, an indirect ophthalmoscope and a hand-held convex lens have been used to observe the fundus during scleral buckling. However, an indirect ophthalmoscope presents reverse images, making it difficult to perform surgical techniques while observing the fundus. In addition, the repeated application and removal of the instrument during surgery results in a time-consuming and inconvenient procedure.This report introduces a modified scleral buckling procedure using a surgical microscope that is capable of image inversion, a wide-field contact lens, and a 25-gauge cannula-based endoillumination system.