ArticleBMC ophthalmology2026
27-gauge direct endoillumination-assisted scleral buckling using a heads-up 3D visualization system: surgical feasibility and outcomes in primary rhegmatogenous retinal detachment.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate the feasibility, anatomical outcomes, visual results, and safety profile of a modified scleral buckling (SB) technique utilizing 27-gauge direct endoillumination under a heads-up three-dimensional (3D) visualization system for primary rhegmatogenous retinal detachment (RRD).
methodsThis retrospective case series included consecutive patients with primary RRD who underwent modified SB surgery at a tertiary referral center. Retinal breaks were identified using a 27-gauge endoillumination probe through a valved trocar under a heads-up 3D visualization system with a non-contact wide-angle viewing lens. Anatomical success after a single surgery was the primary outcome. Secondary outcomes included final best-corrected visual acuity (BCVA) and surgical complications.
resultsTwenty-seven eyes of 27 patients were included, with a mean age of 34.6 ± 12.1 years. Fifteen eyes (56%) were macula-off at presentation. Single-surgery anatomical success was achieved in all cases during a mean follow-up of 9.4 ± 5.9 months. Mean BCVA improved significantly from 0.57 ± 0.55 logMAR preoperatively to 0.21 ± 0.30 logMAR postoperatively (p < 0.001). Twelve eyes (44.4%) achieved a final visual acuity of 20/20. No major intraoperative or postoperative complications, including endophthalmitis, iatrogenic retinal breaks, cataract formation, or vitreous prolapse, were observed.
conclusionsThis modified SB technique using 27-gauge direct endoillumination and heads-up 3D visualization appears to be a feasible and safe approach for selected cases of primary RRD, demonstrating encouraging anatomical and functional outcomes. However, given the retrospective design, small sample size, and absence of a control group, further prospective comparative studies are warranted to validate these findings.
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