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SCLERAL SELF-INDENTATION DURING CHANDELIER-ASSISTED PERIPHERAL VITRECTOMY UNDER AIR FOR RHEGMATOGENOUS RETINAL DETACHMENT: A Retrospective Cohort Study

Ewais, Wael A., MD*,†; Nossair, Ashraf A., MD*,†; Aly, Lamia S., MD*,†

doi: 10.1097/IAE.0000000000001955
Original Study: PDF Only

Purpose: To evaluate incidence of iatrogenic retinal breaks in eyes for whom self-indentation during chandelier-assisted peripheral vitrectomy under air, for primary retinal detachment, had been performed compared with eyes for whom a nonindentation chandelier-assisted peripheral vitrectomy under air had been performed.

Methods: Retrospective cohort study. One hundred and thirty eyes with primary rhegmatogenous retinal detachment were identified. All the patients had undergone a chandelier-assisted peripheral vitrectomy under air. Scleral self-indentation had been used in 68 eyes (study group; indentation), whereas nonindentation had been used in 62 eyes (comparison; nonindentation). Outcome variables included the following: trimming-induced retinal breaks, retinal redetachment rate, final logMAR best-corrected visual acuity, and intraoperative complications.

Results: The number of eyes with trimming-induced retinal break was statistically less in indentation group than in nonindentation group (0/68 and 3/62 eyes, 0% and 4.8%, respectively) (P = 0.04). Redetachment was observed in one eye (indentation) (1/68) and in three eyes (nonindentation) (3/62) (P = 0.267). There was no statistically significant difference in logMAR best-corrected visual acuity between both groups (P = 0.229). Chandelier repositioning was needed in 22 eyes (indentation) compared with 46 eyes (nonindentation) (P < 0.001).

Conclusion: Self-indentation, during chandelier-assisted peripheral vitrectomy under air, enables complete trimming of the vitreous base without causing iatrogenic retinal breaks, with a higher retinal reattachment rate, and with less need for chandelier repositioning than with nonindentation approach. By contrast with previous reports, we consider scleral self-indentation as an advantage for chandelier air vitrectomy.

We compared the incidence of trimming-induced retinal breaks, retinal redetachment rate, and final logMAR best-corrected visual acuity between scleral self-indentation and nonindentation during chandelier-assisted peripheral vitrectomy under air for eyes with primary retinal detachment. We found out that self-indentation enables complete trimming of the vitreous base without causing iatrogenic retinal breaks, with a higher retinal reattachment rate, and with less need for chandelier repositioning than with nonindentation approach.

*Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt; and

Dar El Oyoun Hospital, Cairo, Egypt.

Reprint requests: Wael A. Ewais, MD, Department of Ophthalmology, Faculty of Medicine, Cairo University, Dar El Oyoun Hospital, 24 Shehab Street, Mohandeseen, 11411 Cairo, Egypt; e-mail: waelewais74@gmail.com

None of the authors has any financial/conflicting interests to disclose.

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© 2018 by Ophthalmic Communications Society, Inc.