Scleral buckling is still a useful and effective technique to repair rhegmatogenous retinal detachment (RRD), especially in phakic eyes, but many retinal surgeons have recently preferred to perform pars plana vitrectomy (PPV). Scleral buckling has some disadvantages compared to PPV, such as the requirement for expertise in using the indirect ophthalmoscope in a particular position and the obscured view of the indirect ophthalmoscope in eyes with opaque media or small pupil. Retinal breaks are difficult to identify and treat in eyes with opaque media, small pupil or small retinal holes. However, RRD in young patients without posterior vitreous detachment should be treated by scleral buckling. To minimize these problems, we applied advanced instruments, chandelier illumination and the wide-angle viewing system. Scleral buckling with chandelier illumination could resolve some of the problems. This technique has some advantages and possible disadvantages, but allows scleral buckling surgery with reduced risk of cataract induced by PPV in phakic RRD.
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