COMPARISON OF CRYOTHERAPY AND ILLUMINATED ENDOLASER RETINOPEXY IN CHANDELIER-ASSISTED SCLERAL BUCKLING FOR RHEGMATOGENOUS RETINAL DETACHMENT.

Abstract

To compare anatomical and functional outcomes as well as postoperative complication rates between cryotherapy and illuminated endolaser retinopexy in chandelier-assisted scleral buckling (CASB) for rhegmatogenous retinal detachment. This retrospective study included 63 eyes from 63 patients treated with CASB between January 2021 and January 2024. Group 1 (n = 31) underwent retinopexy with cryotherapy, whereas Group 2 (n = 32) received illuminated endolaser through the same cannula as the chandelier light. All surgeries were performed using a noncontact wide-angle viewing system by a single experienced vitreoretinal surgeon. Outcome measures included best-corrected visual acuity (BCVA), intraocular pressure, swept-source OCT, and postoperative complications. Mean BCVA improved significantly in both groups. In Group 1, BCVA improved from 1.39 ± 0.74 logMAR (approx. Snellen 20/490) to 1.01 ± 0.63 (20/204), P < 0.001. In Group 2, BCVA improved from 1.50 ± 0.67 (20/632) to 1.14 ± 0.66 (20/276), P < 0.001. Final BCVA ( P = 0.21) and retinal reattachment rates ( P = 0.67) were similar. However, cystoid macular edema (CME) occurred significantly more in Group 1 (19.3%) than in Group 2 (3.1%) ( P = 0.04). Rates of epiretinal membrane, cataract, and intraocular pressure elevation did not differ significantly ( P > 0.05). No buckle exposure or infection was observed. Both techniques are effective for CASB. Endolaser provides a lower risk of CME and enhanced surgical precision, suggesting it may be a favorable option in selected cases.