Intraoperative Optical Coherence Tomography for Real-Time Visualization of the Positional Relationship Between Buckling Material and Retinal Breaks During Scleral Buckling for Rhegmatogenous Retinal Detachment

Abstract

To report the usefulness of a new surgical method using intraoperative optical coherence tomography that can more accurately place the buckling material for scleral buckling using a noncontact wide-angle viewing system with a cannula-based chandelier endoilluminator for the treatment of rhegmatogenous retinal detachment.Methods: The medical records of 12 eyes of 11 patients with rhegmatogenous retinal detachment treated with scleral buckling combined with real-time intraoperative optical coherence tomography observation were retrospectively reviewed.Results: Real-time observations of the positional relationship between the protrusion of buckling material and retinal breaks with intraoperative optical coherence tomography revealed that retinal breaks were not properly placed on the protrusion of the buckling material in five eyes, requiring the intraoperative repositioning of the buckling material. Eventually, the scleral buckling combined with real-time intraoperative optical coherence tomography observation yielded the initial anatomical success rates of 100% without noteworthy intraoperative or postoperative complications.Conclusion: This procedure is a novel approach that enables safer and more accurate placement of the buckling material and may contribute to improving the outcomes of scleral buckling in the future.

A Modified Suturing Technique to Produce Temporary Scleral Buckling Effect for Noncomplex Rhegmatogenous Retinal Detachment

“…[6][7][8][9] To decrease the incidence of complications and surgical difficulty, some modifications have been made in recent years, such as the use of absorbable sutures to tighten bands and wide-angle systems to check retinal breaks and ridges formed by the implants. 10,11 However, there are few reports with detailed descriptions of how to have releasable SB with absorbable sutures based on conventional surgical steps. The current article introduces a modified SB technique using a combination of nonabsorbable and absorbable sutures to fix and tighten silicone elements to produce a temporary buckling effect for noncomplex RRD and to investigate the tendency of refractive changes caused by this technique.…”

“…6–9 To decrease the incidence of complications and surgical difficulty, some modifications have been made in recent years, such as the use of absorbable sutures to tighten bands and wide-angle systems to check retinal breaks and ridges formed by the implants. 10,11…”

Impact of scleral tunnel length on the position of intraocular lenses in flanged intrascleral haptic fixation

“…9 Moreover, complications involving the IOL tilt are frequently encountered. 7,19 The IOL tilt can induce coma-like aberrations, potentially compromising visual outcomes, thereby leading to uncorrectable astigmatism. 20 Moreover, tilting may result in serious complications, such as optic capture, iris chafing, and pigmentary dispersion.…”

The State of Intraoperative OCT in Vitreoretinal Surgery: Recent Advances and Future Challenges

“…With regards to ab externo RRD surgery, previous studies showed how scleral buckling and encircling procedures could also benefit from the application of this technology. In particular, Sotani et al [50] reported how iOCT showed a mismatch between the buckle's position and the retinal break in 5 eyes out of 12 cases, therefore helping the surgeons adjust the placing of the band and reach anatomical success in 100% of cases. With regards to ab externo RRD surgery, previous studies showed how scleral buckling and encircling procedures could also benefit from the application of this technology.…”