Innovative surgical techniques of scleral buckling: scleral buckling with wide-angled endoillumination and intraocular irrigation assisted subretinal fluid drainage for Rhegmatogenous retinal detachment

Background: Scleral buckling surgery is still the preferred treatment option for some cases. However, there are still some deficiencies in its illuminating system and surgical procedures, especially for cases of children or adolescents with sticky vitreous accompanied by amount of subretinal fluid accumulation or large retinal tears, as well as cases with intraocular lens implantation or cases where the pupil should not be dilated during surgery. This study aimed to evaluate the modified surgical technique and outcomes of wide-angled endoillumination-assisted scleral buckling (SB) with intraocular irrigation during the procedure of subretinal fluid drainage for rhegmatogenous retinal detachment(RRDs). Methods: A series of 9 eyes of 9 consecutive patients with RRD who underwent the modified SB were included in this study. SB was performed under the wild-field noncontact lens attachend to lumera microcopewith a 25-gauge endoillumination probe. Intraocular irrigation was performed under an supranormal intraocular pressure to facilitates the external drainage of subretinal fluid under the direct visualization until complete retinal reattachment. Results: 8 patients underwent successful primary retinal detachment repair without any intraoperative or post-operative complications. In the other case, although the retina was reattached after the first operation, the retinal hole valve was further pulled due to the vitreous continuous contraction. One month after the operation, the retinal hole opened again, and retinal detachment progressed. Vitrectomy was performed. Conclusions: Wide-angled endoillumination and intraocular irrigation assisted scleral buckling surgery for RRDs, can provide good anatomical and functional outcomes with great advantages and low complication rate.