A guarded light pipe for direct visualization during primary scleral buckling on the Ngenuity platform

Agranat, Joshua S.; Douglas, Vivian Paraskevi; Douglas, Konstantinos A A; Miller, John B.

doi:10.1186/s40942-020-00246-9

Cited by 10 publications

(14 citation statements)

References 14 publications

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“…However, some studies reported different 3D HUVS drawbacks, such as a possible longer surgical time, a challenging learning curve, and a higher surgical workload [ 9 , 11 ]. However, most research focused on vitreoretinal surgery rather than cataract surgery, as the 3D HUVS’s main area of application is still vitreoretinal surgery [ 15 , 16 ]. In addition, no consensus has been reached to measure visual and postural comfort as well as other parameters such as surgeon workload score, maneuverability, teaching potential, and simplicity of use during 3D surgery, thus resulting in many different questionnaires that have been provided to the surgeons to measure these variables.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Heads-Up vs. Standard Operating Microscope for Cataract Surgery: A Systematic Review and Meta-Analysis

et al. 2022

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Background: The surgical time duration, the postoperative best-corrected visual acuity (BCVA), and the incidence rate of intraoperative complications, alongside the vision and posturing parameters, were estimated by systematic review and meta-analysis to compare the three-dimensional (3D) heads-up visualization system (HUVS) and standard operating microscope (SOM) in cataract surgery. Methods: A literature search was conducted using PubMed, Embase, and Scopus on 26 June 2022. The weighted mean difference (WMD) was used to present postoperative BCVA and the mean surgical time duration, whereas the risk ratio (RR) was used to present the incidence rate of intraoperative complications. Publication bias was evaluated with Egger’s test. The Cochrane Collaboration’s Tool for randomized clinical trials, the methodological index for non-randomized, and the Newcastle-Ottawa Scale were used to assess the risk of bias. The research has been registered with the PROSPERO database (identifier, CRD42022339186). Results: In the meta-analysis of five studies with 1021 participants, the pooled weighted mean difference (WMD) of the postoperative BCVA showed no significant difference between patients who underwent HUVS versus SOM cataract surgery (WMD = −0.01, 95% confidence interval (CI): −0.01 −0.02). In the meta-analysis of nine studies with 5505 participants, the pooled WMD of mean surgical time duration revealed no significant difference between patients who underwent HUVS versus SOM cataract surgery (WMD = 0.17, 95% CI: −0.43–0.76). In the meta-analysis of nine studies with 8609 participants, the pooled risk RR associated with intraoperative complications was 1.00 (95% CI, 1.00–1.01). Conclusions: 3D HUVS and SOM provide comparable surgical time duration, postoperative BCVA, and incidence rate of intraoperative complications.

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Section: Introductionmentioning

confidence: 99%

Three-Dimensional Heads-Up vs. Standard Operating Microscope for Cataract Surgery: A Systematic Review and Meta-Analysis

et al. 2022

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“…In 2012, Aras et al [ 4 ] first reported modified scleral buckling using a noncontact wide-angle viewing system combined with a 25-gauge chandelier light source through an uncannulated sclerotomy for retinal visualization. Thereafter, different modified illuminations were tried and reported, such as 25-gauge chandelier light through a transscleral cannula [ 11 ], 25-gaugee “self-retaining endoilluminator” [ 12 ], twin uncannulated 27-gauge chandelier [ 13 ], and a guarded 25-gauge or 27-gauge light pipe [ 14 ]. Recently, Frisina et al reported 213 eyes of primary RRD who underwent microscope-assisted ab externo surgery and demonstrated the safety and efficacy of this technique [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent update in chandelier-assisted scleral buckling includes using 3D visualization system [ 5 , 14 ], antidrying contact lens [ 5 ], combination with an endolaser [ 25 ], and intravitreal injection of hyaluronate [ 26 ]. A new modification that continued to emerge may improve the ergonomics of surgeon and increase the attraction or popularity of chandelier-assisted scleral buckling.…”

Section: Discussionmentioning

confidence: 99%

Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

Zhang

Wei

et al. 2021

BioMed Research International

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Objectives. To report the long-term results of scleral buckling using 25-gauge chandelier illumination. Methods. The medical records of all patients presenting to Shanghai Tenth People’s Hospital with simple rhegmatogenous retinal detachment (RRD) from June 2013 to Oct 2015 were retrospectively reviewed in this consecutive case series. All patients underwent preoperative and postoperative best corrected visual acuity (BCVA), B-ultrasound, fundus photography, and optical coherence tomography examination. Ultrasound biomicroscopy (UBM) was obtained postoperatively. Results. Ten patients (10 eyes) were included in the final analysis. Of 10 patients, the average age was 49.3 ± 18.9 years old, the average duration of RRD was 30.9 ± 53.3 days, and the mean follow-up period was 6.2 ± 0.9 years. There were nine eyes with myopia and four eyes with macular detachment. The primary anatomical success rate was 90%. Five eyes underwent 360-degree band with element surgery, and five eyes underwent element surgery alone. The average length of encircling band and element was 68.2 ± 1.3 mm and 10.5 ± 2.5 mm, respectively. There were no intraoperative or postoperative complications that occurred. The final BCVA was greater than or equal to 20/40 in nine eyes, of which four eyes achieved 20/20. UBM examination of the 25-gauge chandelier insertion site revealed no tissue proliferation. Conclusions. For simple rhegmatogenous retinal detachment treatment, 25-gauge chandelier illumination-assisted scleral buckling is a kind of effective and safe method.

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“…This study retrospectively compared traditional SB technique to a novel technique that utilizes heads-up 3D visualization with a guarded light pipe for the treatment of RRD. 32 This novel technique has only been reported once before, of which outcomes were not formally evaluated. 32 Here, we demonstrate comparable (p = 1.00) single surgery anatomic success rates between traditional SB (87.0%) and 3DGLP (87.5%) for the primary treatment of RRD.…”

Section: Discussionmentioning

confidence: 99%

“…The technique was identical to that previously published. 32 The NGENUITY system was secured at the foot of the patient's bed. Surgeons and trainees wore polarized glasses for intra-operative viewing.…”

Section: Pre-operative and Post-operative Evaluationsmentioning

confidence: 99%

A Comparative Study of Traditional Scleral Buckling to a New Technique: Guarded Light Pipe with Heads-Up Three-Dimensional Visualization

Baldwin¹,

Sokol²,

Ludwig³

et al. 2022

OPTH

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The guarded light pipe is a recently described alternative endoillumination technique to chandelier illumination. We sought to compare the outcomes of scleral buckling (SB) under indirect ophthalmoscopy (ID) to heads-up three-dimensional visualization with a guarded light pipe (3DGLP). Methods: A retrospective comparative study was performed, including 47 eyes that underwent SB for rhegmatogenous retinal detachment (RRD) repair with either traditional ID (n = 31) or 3DGLP (n = 16). Results:The single surgery anatomic success rate was 87.0% in the ID group and 87.5% in the 3DGLP group. The final anatomic success rate was 100% in both groups. The median (interquartile range) post-operative logMAR was 0.10 (0.0-0.20) in the ID group and 0.08 (0.02-0.69) in the 3DGLP group (p = 0.51). The median operative time was 107 (94-123) minutes in the ID group and 100 (90-111) minutes in the 3DGLP group (p = 0.25). Among eyes that underwent subretinal fluid drainage, the operative time was significantly longer in the ID group compared to the 3DGLP group, 113 (100-135) minutes vs 93 (85-111) minutes (p = 0.035). There were no post-operative complications in the ID group and one complication of self-resolving vitreous hemorrhage associated with a malfunctioning cryoprobe in the 3DGLP group (p = 0.34). There were no cases of post-operative cataract progression in either group. Conclusion:Compared to traditional SB, 3DGLP improves ergonomics and educational value with similar anatomical, visual, intra and post-operative outcomes and may result in shorter operative time in cases requiring subretinal fluid drainage.

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A guarded light pipe for direct visualization during primary scleral buckling on the Ngenuity platform

Cited by 10 publications

References 14 publications

Three-Dimensional Heads-Up vs. Standard Operating Microscope for Cataract Surgery: A Systematic Review and Meta-Analysis

Three-Dimensional Heads-Up vs. Standard Operating Microscope for Cataract Surgery: A Systematic Review and Meta-Analysis

Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

A Comparative Study of Traditional Scleral Buckling to a New Technique: Guarded Light Pipe with Heads-Up Three-Dimensional Visualization

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