Comparison of Chandelier-Assisted versus Standard Scleral Buckling for the Treatment of Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Ophthalmologica. 2024;247(5-6):345-354. doi: 10.1159/000540820. Epub 2024 Aug 19.

Abstract

Introduction: Compare the anatomical and functional outcomes, operation duration, and complication rates between standard scleral buckling (SSB) and chandelier-assisted scleral buckling (CSB) for phakic eyes with rhegmatogenous retinal detachment (RRD).

Methods: PubMed, Embase, and Cochrane Library databases were searched from inception to June 2024. The primary endpoint will be set as a final success. The secondary endpoint will be primary success, operation time, and final BCVA.

Results: Our meta-analysis showed that there is no statistical difference between CSB and SSB for the final success rate (RR = 1.00, 95% CI = 0.97-1.03). For the primary success rate, there is no statistical difference between CSB and SSB (RR = 1.00, 95% CI = 0.94-1.06). For operation time, our meta-analysis showed that the CSB group is less than the SSB group (pooled MD = -15.8, 95% CI = -22.60 to -9.00). For postoperative complications, our study shows that the CSB group presented with lower pooled risk than the SSB group (RR = 0.59, 95% CI = 0.41-0.89). There is a trend that the ERM formation risk is higher in the CSB group if there is no routine suture for the sclerotomy (p = 0.08).

Conclusion: CSB showcases a significantly reduced operation duration and less postoperative complication in contrast to the SSB group, maintaining comparable primary and ultimate anatomical success rates as well as final BCVA.

Keywords: Chandelier-assisted scleral buckling surgery; Epiretinal membranes; Rhegmatogenous retinal detachment; Standard scleral buckling.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Humans
  • Postoperative Complications / epidemiology
  • Retinal Detachment* / diagnosis
  • Retinal Detachment* / surgery
  • Scleral Buckling* / methods
  • Visual Acuity*

Grants and funding

This study was not supported by any sponsor or funder.