27 Gauge Twinlight Chandelier as an All-Purpose Light Source in VR Surgery

Enrico Bertelli, Bolzano, Italy

Advantages:

27G Eckardt twinlight chandelier (DORC, Zuidland, Holland) is a light probe that has been made available on the market since mid-2008, with the purpose of facilitating bimanual vitreoretinal surgery. The instrument consists of 2 separate optic fibers, that can be independently inserted through the sclera.

Methods:

In 15 consecutive eyes 27G twinlight chandelier was used as exclusive light source in transconjunctival 23G sutureless vitrectomy. Treated vitreoretinal pathology included 3 cases of vitreous haemorrhage in PDR, 5 cases of diabetic macular edema, 3 cases of retinal detachment and 4 cases of macular pucker. The first optic fiber was invariably placed in the inferonasal quadrant, 3,5 mm from the limbus. The second optic fiber was placed into the valved microcannula that was not engaged by the vitrectomy probe or the microforceps. When illumination of the macula for posterior hyaloid or ILM peeling was necessary, the second 27G optic fiber was inserted into a 23G backflush needle, holding the needle at its base, in order to stabilize the light source through the sclerotomy.

Effectiveness / Safety:

With a single light probe all needs of endoillumination were satisfied. Indentation of the surgeon was comfortable for vitrectomy at the vitreous base and endolaser, also thank to the DORC valved microcannula system. Macular endoillumination was also efficient, with the second optic fiber held through the backflush needle (very recently a guidance needle was made available on the market for this purpose). No complications related to the technique were observed.

Take home message:

The 27 G twinlight chandelier is a multi-purpose light probe, fit for all kinds of vitreoretinal surgery.