Authors: Cesare Forlini, Matteo Forlini, Paolo Rossini, Ravenna, Italy

Advantages:

The Authors present the routine use of trans-conjunctival, xenon light, chandeliers during vitreo-retinal procedures. The goal of this technique, even in uncomplicated cases, is to obtain a total control of the procedure during all the surgical steps, without the need of an assistant’s help to work in the periphery and for bimanual surgery.

Methods:

Two 27g xenon chandelier lights (Brightstar by DORC, PHOTON 2 by Sinergetics) are used. The tip of the optic fiber is inserted at 12 o’clock, 3.5 mm from the limbus, with previous scleral tunnel made by a 27g needle. A complete vitrectomy is performed using wide angle viewing system (BIOM). At the end of the procedure, the light is removed and the hole can be sutureless or closed with 7/8-0 stich.

Effectiveness / Safety:

867 procedures since 2007. No chandelier-related complications occurred. The use of chandeliers (mono- or twins) with panoramic lights and wide-angle viewing systems (BIOM) allow to reduce intraoperative complications, detecting and treating eventual peripheral retinal breaks and performing a complete vitrectomy. This technique, allows always bimanual surgery, vey useful during surgery, mainly to manage intraoperative complications. The chandelier overcomes the hypothetical difficulties given by the use of alternative illumination systems like pipe light or slit lamp, and gives the surgeon the opportunity to perform all procedures by himself.