Skip to main content
Top
Published in: International Ophthalmology 1/2024

Open Access 01-12-2024 | Vitrectomy | Original Paper

Evaluation of the (Baha) technique of scleral indentation using a self-retained scleral indenter during vitrectomy surgery: a randomized trial

Authors: Samir El Baha, Moutaz Ghandour, Islam S. H. Ahmed

Published in: International Ophthalmology | Issue 1/2024

Login to get access

Abstract

Aims

The current study compared a novel technique of scleral indentation using the self-retaining Leyla retractor to the conventional scleral self-indentation with the chandelier light.

Methods

Patients with rhegmatogenous retinal detachment were randomized on a 1:1 basis to either have the (Baha) indentation using a tip of a thimble scleral indenter welded to the support for the Leyla retractor system or to have the conventional scleral indentation while using a 25-gauge chandelier light. A video was recorded for the surgery of all the cases and reviewed by another consultant masked to the type of indentation. The indentation duration (i.e., the time in seconds between the first appearance of a hump due to scleral indentation in the recorded video until its final disappearance) was measured for every case.

Results

The current study included 60 eyes of 60 adults with a mean age of 59.6 ± 9.8 years. Thirty-nine of the eyes were phakic and 21 were pseudophakic. The mean indentation time was 618 ± 87 and 696 ± 72 s in (Baha) indentation and conventional indentation groups, respectively. The difference was not statistically significant (p = 38). There was a positive correlation between the vertical palpebral fissure height and the indentation duration for both (Baha) indentation (r = 0.58) and conventional indentation groups (r = 0.42). Readjustment of the chandelier endo-illumination was required in 19 cases (63.3%) in the conventional indentation group. Iatrogenic breaks or accidental crystalline lens touch did not occur in any case.

Conclusion

The (Baha) technique is effective and safe, especially in patients with a larger palpebral fissure.
Appendix
Available only for authorised users
Literature
1.
go back to reference Erdogan G, Unlu C, Karasu B, Kardes E, Ergin A (2016) Comparing peripheral vitrectomy under air and fluid infusion for primary rhegmatogenous retinal detachment. Retina 36(7):1281–1284CrossRefPubMed Erdogan G, Unlu C, Karasu B, Kardes E, Ergin A (2016) Comparing peripheral vitrectomy under air and fluid infusion for primary rhegmatogenous retinal detachment. Retina 36(7):1281–1284CrossRefPubMed
2.
go back to reference Kuhn F, Aylward B (2013) Rhegmatogenous retinal detachment: a reappraisal of its pathophysiology and treatment. Ophthalmic Res 51(1):15–31CrossRefPubMed Kuhn F, Aylward B (2013) Rhegmatogenous retinal detachment: a reappraisal of its pathophysiology and treatment. Ophthalmic Res 51(1):15–31CrossRefPubMed
3.
go back to reference Lumi X, Lužnik Z, Petrovski G, Petrovski BÉ, Hawlina M (2016) Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment. BMC Ophthalmol 16(1):1–9CrossRef Lumi X, Lužnik Z, Petrovski G, Petrovski BÉ, Hawlina M (2016) Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment. BMC Ophthalmol 16(1):1–9CrossRef
4.
go back to reference Shuey NH, Anderson AJ, Siderov J (1995) Scleral indentation: a review of the procedure and indications for use. Clin Exp Optom 78(3):106–109CrossRef Shuey NH, Anderson AJ, Siderov J (1995) Scleral indentation: a review of the procedure and indications for use. Clin Exp Optom 78(3):106–109CrossRef
5.
go back to reference Altan T, Ozbilen KT, Cetin T, Kapran Z (2017) Results of peripheral vitrectomy under air in rhegmatogenous retinal detachment. Ophthalmic Surg Lasers Imaging Retina 48(1):51–54CrossRefPubMed Altan T, Ozbilen KT, Cetin T, Kapran Z (2017) Results of peripheral vitrectomy under air in rhegmatogenous retinal detachment. Ophthalmic Surg Lasers Imaging Retina 48(1):51–54CrossRefPubMed
6.
go back to reference Ewais WA, Nossair AA, Aly LS (2019) Scleral self-indentation during chandelier-assisted peripheral vitrectomy under air for rhegmatogenous retinal detachment: a Retrospective Cohort Study. Retina 39(2):358–363CrossRefPubMed Ewais WA, Nossair AA, Aly LS (2019) Scleral self-indentation during chandelier-assisted peripheral vitrectomy under air for rhegmatogenous retinal detachment: a Retrospective Cohort Study. Retina 39(2):358–363CrossRefPubMed
7.
go back to reference Eckardt C (2003) Twin lights: a new chandelier illumination for bimanual surgery. Retina 23(6):893–894CrossRefPubMed Eckardt C (2003) Twin lights: a new chandelier illumination for bimanual surgery. Retina 23(6):893–894CrossRefPubMed
8.
go back to reference Williams GA (2008) 27-gauge Twinlight chandelier illumination system for bimanual transconjunctival vitrectomy. Retina 28(3):518–519CrossRef Williams GA (2008) 27-gauge Twinlight chandelier illumination system for bimanual transconjunctival vitrectomy. Retina 28(3):518–519CrossRef
9.
go back to reference Oshima Y, Awh CC, Tano Y (2007) Self-retaining 27-gauge transconjunctival chandelier endoillumination for panoramic viewing during vitreous surgery. Am J Ophthalmol 143(1):166–167CrossRefPubMed Oshima Y, Awh CC, Tano Y (2007) Self-retaining 27-gauge transconjunctival chandelier endoillumination for panoramic viewing during vitreous surgery. Am J Ophthalmol 143(1):166–167CrossRefPubMed
10.
go back to reference Oshima Y (2013) Chandelier endoillumination in vitreoretinal surgery. Retina Today 8:68–72 Oshima Y (2013) Chandelier endoillumination in vitreoretinal surgery. Retina Today 8:68–72
11.
go back to reference Yasargil M, Fox J (1974) The microsurgical approach to acoustic neurinomas. Surg Neurol 2(6):393–398PubMed Yasargil M, Fox J (1974) The microsurgical approach to acoustic neurinomas. Surg Neurol 2(6):393–398PubMed
12.
go back to reference Charles S (2008) Illumination and phototoxicity issues in vitreoretinal surgery. Retina 28(1):1–4CrossRefPubMed Charles S (2008) Illumination and phototoxicity issues in vitreoretinal surgery. Retina 28(1):1–4CrossRefPubMed
13.
go back to reference Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y (2007) Thermal injury caused by chandelier fiber probe. Am J Ophthalmol 143(1):167–169CrossRefPubMed Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y (2007) Thermal injury caused by chandelier fiber probe. Am J Ophthalmol 143(1):167–169CrossRefPubMed
14.
go back to reference Sakaguchi H, Oshima Y, Nishida K, Awh CC (2011) A 29/30-gauge dual-chandelier illumination system for panoramic viewing during microincision vitrectomy surgery. Retina 31(6):1231–1233CrossRefPubMed Sakaguchi H, Oshima Y, Nishida K, Awh CC (2011) A 29/30-gauge dual-chandelier illumination system for panoramic viewing during microincision vitrectomy surgery. Retina 31(6):1231–1233CrossRefPubMed
Metadata
Title
Evaluation of the (Baha) technique of scleral indentation using a self-retained scleral indenter during vitrectomy surgery: a randomized trial
Authors
Samir El Baha
Moutaz Ghandour
Islam S. H. Ahmed
Publication date
01-12-2024
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 1/2024
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-024-03028-6

Other articles of this Issue 1/2024

International Ophthalmology 1/2024 Go to the issue