Twenty-nine-gauge dual-chandelier retroillumination for the non-open-sky continuous curvilinear capsulorhexis in the penetrating keratoplasty triple procedure

Abstract

We describe a technique for the penetrating keratoplasty (PKP) triple procedure that uses 29-gauge dual-chandelier illumination during creation of a non-open-sky continuous curvilinear capsulorhexis (CCC). The chandeliers are inserted through the pars plana into the vitreous cavity through the bulbar conjunctiva at the 3 o'clock and 9 o'clock positions. We compared this approach with that of a core vitrectomy, in which a single 25-gauge port is inserted into the vitreous cavity transconjunctivally through the upper temporal pars plana. The area of halation around the corneal opacity was significantly smaller in the 29-gauge group than in the 25-gauge group. The reduction in halation improved visibility of the anterior capsule and enabled the surgeon to perform CCC with greater safety. The 29-gauge chandelier system was more suitable than the 25-gauge chandelier system for the non-open-sky CCC component of the PKP triple procedure.

Effectiveness of Scleral Buckling with a Wide-Field Surgical Microscope and Chandelier Illumination in Retinal Detachment Repair

“…Recently, Bilgin and Kayikcioglu [21] have reported chandelier-assisted retro-illumination for phacoemulsification in phacovitrectomy. Yokokura et al [22] have presented a similar way to use 29-G dual-chandelier illumination during creation of a non-open-sky continuous curvilinear capsulorhexis in penetrating keratoplasty triple procedure. The chandelier illuminating system is used even in Descemet membrane endothelial keratoplasty surgery due to its good visibility for anterior chamber [23].…”