title: Combined treatment of minimally invasive 23-G vitrectomy and chandelier for superior bullous rhegmatogenous retinal detachment.
abstract: OBJECTIVE
  To investigate the clinical efficacy of minimally invasive 23G vitrectomy combined with chandelier for the treatment of superior bullous rhegmatogenous retinal detachment (SBRRD).
  
  
  METHODS
  A retrospective case series study of 50 patients with SBRRD was conducted. Each of these patients received minimally invasive 23G vitrectomy in one of their eye. A trocar was indwelled with two-step 23-G incision, and the chandelier was inserted in the inferior 6 o'clock pars plana. The tear was closed with 23-G vitrectomy combined with endolaser photocoagulation and infused with perfluoropropane (C3F8) under non-contact wide-angle lens. Postoperative follow-up ranged from 5-49 months (mean 23.9±1.3 months). Intraoperative and postoperative complications, postoperative conjunctival hyperemia, eye irritation signs and inflammation reactions, retinal anatomic reduction rate, best corrected visual acuity (BCVA) and intraocular pressure (IOP) changes were analyzed.
  
  
  RESULTS
  The intraoperative scleral incision leakage required 17 sutures (34%). No complications, such as iatrogenic retinal breaks and hemorrhage occurred. The postoperative conjunctival hyperemia, eye irritation signs and inflammation reactions were mild. Transient low IOP occurred in one eye (2%) on the first day postoperatively and recovered on the next day. Transient low IOP occurred in eyes of 16 subjects (32%) and recovered after lowering IOP therapy within an average of 4 days. No complications, such as hemorrhage, effusion, choroidal detachment and endophthalmitis were observed. Forty-nine subjects (98%) had retinal reattachment in their eyes after a single surgery, and 100% eyes showed final retinal reattachment. The preoperative and postoperative BCVAs were 4.61±0.19 and 4.70±0.19, respectively, in 8 patients without detached macula, and the difference was not statistically significant (t = 2.20, p >0.05).
  
  
  CONCLUSIONS
  Minimally invasive 23G vitrectomy combined with chandelier is a safe and effective surgical approach for the treatment of SBRRD.
authors.affiliation: Department of Ophthalmology, The Municipal Affiliated Hospital of Xuzhou Medical College, Eye Institute of Xuzhou, Jiangsu, China. lisuyan1226@126.com.
authors.forename: S
authors.initials: S
authors.lastname: Liu
authors.forename: S-Y
authors.initials: SY
authors.lastname: Li
authors.forename: Z-P
authors.initials: ZP
authors.lastname: Zhang
authors.forename: S-J
authors.initials: SJ
authors.lastname: Ji
authors.forename: H-Y
authors.initials: HY
authors.lastname: Liu
authors.forename: C-P
authors.initials: CP
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011184:Postoperative Period; D012163:Retinal Detachment / Q000628:therapy*; D012189:Retrospective Studies; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*