[1]刘晶劼,刘勃实,李筱荣.吊顶灯辅助照明技术在巩膜扣带术治疗孔源性视网膜脱离中的应用进展[J].眼科新进展,2023,43(10):814-818.[doi:10.13389/j.cnki.rao.2023.0164]
　LIU Jingjie,LIU Boshi,LI Xiaorong.Advances in the application of chandelier illumination system in scleral buckling for rhegmatogenous retinal detachment[J].Recent Advances in Ophthalmology,2023,43(10):814-818.[doi:10.13389/j.cnki.rao.2023.0164]
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吊顶灯辅助照明技术在巩膜扣带术治疗孔源性视网膜脱离中的应用进展/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
43卷
期数:
2023年10期
页码:
814-818
栏目:
文献综述
出版日期:
2023-10-05

文章信息/Info

Title:
Advances in the application of chandelier illumination system in scleral buckling for rhegmatogenous retinal detachment
作者:
刘晶劼; 刘勃实; 李筱荣
300384　天津医科大学眼科医院、眼视光学院、眼科研究所，国家眼耳鼻喉疾病临床医学研究中心天津市分中心，天津市视网膜功能与疾病重点实验室
Author(s):
LIU Jingjie; LIU Boshi; LI Xiaorong
Tianjin Key Laboratory of Retinal Functions and Disease,Tianjin Branch of National Clinical Research Center for Ocular Disease,Eye Institute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 300384,China
关键词:
孔源性视网膜脱离; 吊顶灯; 巩膜扣带术
Keywords:
rhegmatogenous retinal detachment;  chandelier;  scleral buckling
分类号:
R779.62
DOI:
10.13389/j.cnki.rao.2023.0164
文献标志码:
A
摘要:
随着玻璃体切割术技术的进步，越来越多的医生倾向于选择玻璃体切割术治疗孔源性视网膜脱离（RRD）。但是对于年轻的、视网膜裂孔存在于下方或周边的患者，巩膜扣带术仍是最佳选择。吊顶灯技术最初应用于复杂的玻璃体切割术中，在广泛照明下，玻璃体及视网膜病变情况清晰可见，同时吊顶灯对玻璃体干扰较小。目前，许多国内外眼底病医生开始尝试在吊顶灯辅助照明下进行巩膜扣带术治疗RRD。由于其可以在直视下进行放液、冷冻及裂孔查找与定位，术后视网膜复位率较高，并且眼内感染及切口渗漏等并发症非常少见。因此，吊顶灯辅助照明技术让眼底病外科医生重燃对巩膜扣带术的兴趣，避免玻璃体切割术在RRD中的过度应用。
Abstract:
With the advancement of vitrectomy, more and more doctors tend to choose vitrectomy for rhegmatogenous retinal detachment (RRD). But for young patients with inferior or peripheral retinal breaks, scleral buckling remains the best option. The chandelier illumination system was originally used in complex vitrectomy. Under the wide-range lighting, the vitreous and retinopathy conditions are clearly visible, and the chandelier illumination system interferes less with the vitreous body. At present, many doctors at home and abroad have adopted scleral buckling to treat RRD with the assistance of the chandelier illumination system. Because the operations of drainage, cryocoagulation, break search and location can be performed under direct vision, the postoperative retinal reattachment rate is higher, and complications such as intraocular infection and incision leakage are less. Therefore, chandelier illumination has renewed fundus disease surgeons’ interest in scleral buckling, avoiding the overuse of vitrectomy in RRD.

参考文献/References:

［1］　HMAN T,GAWRIYSKI L,MIETTINEN S,VARJOSALO M,LOUKOVAARA S.Molecular pathogenesis of rhegmatogenous retinal detachment［J］.Sci Rep,2021,11:966.
［2］　WARREN A,WANG D W,LIM J I.Rhegmatogenous retinal detachment surgery:a review［J］.Clin Exp Ophthalmol,2023,51(3):271-279.
［3］　CUSTODIS E.Treatment of retinal detachment by circumscribed diathermal coagulation and by scleral depression in the area of tear caused by imbedding of a plastic implant［J］.Klin Monbl Augenheilkd Augenarztl Fortbild,1956,129(4):476-495.
［4］　SCHEPENS C L,OKAMURA I D,BROCKHURST R J.The scleral buckling procedures.I.Surgical techniques and management［J］.AMA Arch Ophthalmol,1957,58(6):797-811.
［5］　WANG A,SNEAD M P.Scleral buckling：a brief historical overview and current indications［J］.Graefes Arch Clin Exp Ophthalmol,2020,258(3):467-478.
［6］　NICHANI P A H,DHOOT A S,POPOVIC M M,ESHTIAGHI A,MIHALACHE A,SAYAL A P,et al.Scleral buckling alone or in combination with pars plana vitrectomy for rhegmatogenous retinal detachment repair:a meta-analysis of 7 212 eyes［J］.Ophthalmologica,2022,245(4):296-314.
［7］　SHU I,ISHIKAWA H,NISHIKAWA H,MORIKAWA S,OKAMOTO F,SAKAMOTO T,et al.Scleral buckling versus vitrectomy for young Japanese patients with rhegmatogenous retinal detachment in the era of microincision surgery:real-world evidence from a multicentre study in Japan［J］.Acta Ophthalmol,2019,97(5):e736-e741.
［8］　GHARBIYA M,VISIOLI G,IANNETTI L,IANNACCONE A,TAMBURRELLI A C,MARENCO M,et al.Comparison between scleral buckling and vitrectomy in the onset of cystoid macular edema and epiretinal membrane after rhegmatogenous retinal detachment repair［J］.Retina,2022,42(7):1268-1276.
［9］　FALLICO M,ALOSI P,REIBALDI M,LONGO A,BONFIGLIO V,AVITABILE T,et al.Scleral buckling:a review of clinical aspects and current concepts［J］.J Clin Med,2022,11(2):314.
［10］　DHOOT A S,POPOVIC M M,NICHANI P A H,ESHTIAGHI A,MIHALACHE A,SAYAL A P,et al.Pars Plana vitrectomy versus scleral buckle:a comprehensive meta-analysis of 15 947 eyes［J］.Surv Ophthalmol,2022,67(4):932-949.
［11］　BITEN H,REDD T K,MOLETA C,CAMPBELL J P,OSTMO S,JONAS K,et al.Diagnostic accuracy of ophthalmoscopy vs telemedicine in examinations for retinopathy of prematurity［J］.JAMA Ophthalmol,2018,136(5):498.
［12］　RIBEIRO L,OLIVEIRA J,KUROIWA D,KOLKO M,FERNANDES R,JUNIOR O,et al.Advances in vitreoretinal surgery［J］.J Clin Med,2022,11(21):6428.
［13］　JO J,MOON B G,LEE J Y.Scleral buckling using a non-contact wide-angle viewing system with a 25-gauge chandelier endoilluminator［J］.Korean J Ophthalmol,2017,31(6):533.
［14］　MEHTA S,HUBBARD G B.Avoiding neck strain in vitreoretinal surgery：an ergonomic approach to indirect ophthalmoscopy and laser photocoagulation ［J］.Retina,2013,33(2):439-441.
［15］　SHAW C,BOURKIZA R,WICKHAM L,MCCARTHY I,MCKECHNIE C.Mechanical exposure of ophthalmic surgeons:a quantitative ergonomic evaluation of indirect ophthalmoscopy and slit-lamp biomicroscopy［J］.Can J Ophthalmol,2017,52(3):302-307.
［16］　TIEGER M G,MOUSSA K,KIM L A,ELIOTT D.The history of visualization in vitrectomy surgery［J］.Int Ophthalmol Clin,2019,60(1):1-15.
［17］　CAPOROSSI T,FINOCCHIO L,BARCA F,FRANCO F,TARTARO R,RIZZO S.Scleral buckling for primary rhegmatogenous retinal detachment using a noncontact wide-angle viewing system with a cannula-based 27 G chandelier endoilluminator［J］.Retina,2019,39(1):S144-S150.
［18］　ZNAOR L,MEDIC A,BINDER S,VUCINOVIC A,MARIN LOVRIC J,PULJAK L.Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments［J］.Cochrane Database Syst Rev,2019,3(3):CD009562.
［19］　SAVASTANO A,WEINBERG T,FARALDI F,CAPOROSSI T,RIZZO S.Scleral buckling using chandelier and releasable suture:a useful surgical variant［J］.Retina,2020,43(2):363-366.
［20］　ASSI A,ABDELMASSIH Y,EL-KHOURY S.Endoillumination-assisted modified scleral buckling［J］.Retina,2018,38(2):320-324.
［21］　DE OLIVEIRA P R C,BERGER A R,CHOW D R.Vitreoretinal instruments:vitrectomy cutters,endoillumination and wide-angle viewing systems［J］.Int J Retina Vitreous,2016,2:28.
［22］　HEINZ F,KOCH J,PAWLOWSKI D,SPITZNAS M.A multiport illumination system for panoramic bi-manual vitreous surgery［J］.Graefes Arch Clin Exp Ophthalmol,1991,229(5):425-429.
［23］　CHOW D R.The evolution of endoillumination［J］.Dev Ophthalmol,2014,54:77-86.
［24］　OSHIMA Y,AWH C C,TANO Y.Self-retaining 27-gauge transconjunctival chandelier endoillumination for panoramic viewing during vitreous surgery［J］.Am J Ophthalmol,2007,143(1):166-167.
［25］　张来霞,郝风芹,李聪伶,王清秀,范东霞.23 G微创玻璃体手术联合吊顶灯照明系统治疗复杂性外伤性视网膜脱离［J］.眼科新进展,2016,36(1):78-80.
ZHANG L X,HAO F Q,LI C L,WANG Q X,FAN D X.23-gauge micro-invasive vitrectomy combined with chandelier illumination for traumatic retinal detachment［J］.Rec Adv Ophthalmol,2016,36(1):78-80.
［26］　EWAIS W A,NOSSAIR A A,ALY L S.Scleral self-indentation during chandelier-assisted peripheral vitrectomy under air for rhegmatogenous retinal detachment:a retrospective cohort study ［J］.Retina,2019,39(2):358-363.
［27］　SAKAGUCHI H,OSHIMA Y,NISHIDA K,AWH C C.A 29/30-gauge dual-chandelier illumination system for panoramic viewing during microincision vitrectomy surgery［J］.Retina,2011,31(6):1231-1233.
［28］　李杰,刘三梅,李芳,董文韬,钟捷.27 G与25 G微创玻璃体切割术治疗孔源性视网膜脱离的对比分析［J］.眼科新进展,2018,38(11):1050-1054.
LI J,LIU S M,LI F,DONG W T,ZHONG J.Retrospective comparison of 27-gauge and 25-gauge microincision vitrectomy surgery for the treatment of primary rhegmatogenous retinal detachment［J］.Rec Adv Ophthalmol,2018,38(11):1050-1054.
［29］　KOELBL P S,LINGENFELDER C,SPRAUL C W,KAMPMEIER J,KOCH F H,KIM Y K,et al.An intraocular micro light-emitting diode device for endo-illumination during pars plana vitrectomy［J］.Eur J Ophthalmol,2019,29(1):75-81.
［30］　LI H,ZHANG C,WEI J,KEYAL K,WANG F.Six-year outcomes of 25-gauge chandelier illumination-assisted scleral buckling［J］.Biomed Res Int,2021,2021:4628160.
［31］　JEON G S,HAN J.Effectiveness of scleral buckling with a wide-field surgical microscope and chandelier illumination in retinal detachment repair［J］.Ophthalmologica,2019,242(1):31-37.
［32］　ARAS C,UCAR D,KOYTAK A,YETIK H.Scleral buckling with a non-contact wide-angle viewing system［J］.Ophthalmologica,2012,227(2):107-110.
［33］　IMAI H,TAGAMI M,AZUMI A.Scleral buckling for primary rhegmatogenous retinal detachment using noncontact wide-angle viewing system with a cannula-based 25 G chandelier endoilluminator［J］.Clin Ophthalmol,2015:2103.
［34］　ROCA J A,MAIA M,SANTOS CRUZ N F,POLIZELLI M U,CHHABLANI J,GANGAKHEDKAR S,et al.Non-contact wide-angled visualization with chandelier-assisted scleral buckling for primary uncomplicated rhegmatogenous retinal detachment［J］.Graefes Arch Clin Exp Ophthalmol,2020,258(9):1857-1861.
［35］　TIEGER M G,RODRIGUEZ M,WANG J C,OBEID A,RYAN C,GAO X,et al.Impact of contact versus non-contact wide-angle viewing systems on outcomes of primary retinal detachment repair (PRO study report number 5)［J］.Br J Ophthalmol,2021,105(3):410-413.
［36］　NAGPAL M,BHARDWAJ S,MEHROTRA N.Scleral buckling for rhegmatogenous retinal detachment using vitrectomy-based visualization systems and chandelier illumination［J］.Asia Pac J Ophthalmol,2013,2(3):165-168.
［37］　HU Y,SI S,XU K,CHEN H,HAN L,WANG X,et al.Outcomes of scleral buckling using chandelier endoillumination［J］.Acta Ophthalmol,2017,95(6):591-594.
［38］　NOSSAIR A A,EWAIS W A,EISSA S A.Chandelier-assisted scleral buckling using wide angle viewing contact lens for pseudophakic retinal detachment repair［J］.Int J Ophthalmol,2019,11(4)::627-633.
［39］　YOKOYAMA T,KANBAYASHI K,YAMAGUCHI T.Scleral buckling procedure with chandelier illumination for pediatric rhegmatogenous retinal detachment［J］.Clin Ophthalmol,2015,9:169-173.
［40］　GAO L,CUI L,YIM C K,LOU H,WU P.Segmental scleral buckling without sling sutures around the muscles［J］.Eur J Ophthalmol,2020,30(3):616-618.
［41］　AGARWAL L,AGRAWAL N.Outcome of non-drainage scleral buckling in primary rhegmatogenous retinal detachment［J］.Nep J Ophthalmol,2021,13(1):65-72.
［42］　MARKAN A,DOGRA M,AYYADURAI N,SINGH R.A hybrid 26 G needle drainage technique in scleral buckling:a mini scleral cut-down［J］.Indian J Ophthalmol,2022,70(10):3603.
［43］　MAFI M,MIRGHORBANI M,GHAHVEHCHIAN H,MOHAMMADI S S,RIAZI-ESFAHANI H,KHALILI POUR E,et al.Modified encircling scleral buckle technique without subretinal fluid drainage or retinopexy［J］.Ophthalmol Ther,2020,9(3):641-651.
［44］　NARAYANAN R,TYAGI M,HUSSEIN A,CHHABLANI J,APTE R S.Scleral buckling with wide-angled endoillumination as a surgical educational tool［J］.Retina,2016,36(4):830-833.
［45］　COHEN E,ROSENBLATT A,BORNSTEIN S,LOEWENSTEIN A,BARAK A,SCHWARTZ S.Wide-angled endoillumination vs traditional scleral buckling surgery for retinal detachment:a comparative study［J］.Clin Ophthalmol,2019,13:287-293.
［46］　VALERIO P,MICHELE L,CARLO I,ANTONELLO I,AGOSTINO D,SANDRO S,et al.Scleral buckling with chandelier illumination system in rhegmatogenous retinal detachment surgery:a large case series［J］.Int Eye Sci,2018,18(10):1763-1766.
［47］　HONG I H,JEON G S,HAN J R.Comparison of scleral buckling and vitrectomy using wide angle viewing system for rhegmatogenous retinal detachment ［J］.Semin Ophthalmol,2020,35(5/6):307-312.
［48］　SAKONO T,OTSUKA H,SHIIHARA H,YOSHIHARA N,SAKAMOTO T.Acute bacterial endophthalmitis after scleral buckling surgery with chandelier endoillumination［J］.Am J Ophthalmol Case Rep,2017,8:7-10.
［49］　ENGLISH J F,BARRY R,ESSEX R W.Postoperative endophthalmitis following chandelier-assisted scleral buckle for primary repair of rhegmatogenous retinal detachment［J］.Acta Ophthalmol,2019,97(1):e130-e131.
［50］　SEZER T,ALTINISIK M,GULER E M,KOCYIGIT A,OZDEMIR H,KOYTAK A.Evaluation of xenon,light-emitting diode (LED) and halogen light toxicity on cultured retinal pigment epithelial cells［J］.Cutan Ocul Toxicol,2019,38(2):125-130.
［51］　KLBL P S,LINDNER C,LINGENFELDER C,DEUCHLER S,SINGH P,KOCH F H J,et al.Fiberless miniature chandelier LED endoilluminator for pars Plana vitrectomy［J］.Ophthalmologe,2016,113(1):47-51.
［52］　MOHAMED S,CLAES C,TSANG C W.Review of small gauge vitrectomy:progress and innovations［J］.J Ophthalmol,2017,2017:6285869.
［53］　LA SPINA C,DEL TURCO C,BOGETTO C,PANICO E,GIOBBIO D C,PANICO C.Wide-angle 3D viewing system with valved trocar applied to chandelier-assisted scleral buckling［J］.Eur J Ophthalmol,2021,31(2):804-806.
［54］　BALDWIN G,SOKOL J T,LUDWIG C A,MILLER J B.A comparative study of traditional scleral buckling to a new technique:guarded light pipe with heads-up three-dimensional visualization［J］.Clin Ophthalmol,2022,16:3079-3088.

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备注/Memo:
国家自然科学基金面上项目（编号：82171085）
更新日期/Last Update: 2023-10-05