Four-port Vitrectomy in Rhegmatogenous Retinal Detachment

Purpose: The study investigated the results of direct surgical scleral depression using four ports and the chandelier lighting sys-tem in rhegmatogenous retinal detachment. Methods: Anatomical and functional success rates and complications were analyzed in 179 eyes diagnosed with rhegmatoge-nous retinal detachment that underwent primary vitrectomy using four ports at our hospital between March 2012 and February 2022. Results: A total of 168 (93.9%) eyes had anatomical success without reoperation while 11 (6.1%) developed recurrence. However, the final success rate was 100%. The best-corrected visual acuity improved significantly from logarithm of the mini-mum angle of resolution (logMAR) 1.03 & PLUSMN; 0.92 to logMAR 0.24 & PLUSMN; 0.39 after surgery (p < 0.001). Complications included a tempo-rary increase in the intraocular pressure (n = 3, 1.7%), leakage through the scleral incision (n = 2, 1.1%), hyphema and vitreous hemorrhage (n = 10, 5.6%), and iatrogenic retinal break (n = 1, 0.6%), but these improved after treatment. Conclusions: Four-port vitrectomy for rhegmatogenous retinal detachment in which scleral depression is directly performed us-ing the chandelier lighting system is a useful surgical method. It allows effective visualization of the peripheral retina regardless of the assistant's proficiency which results in a more meticulous surgery. The anatomical and functional results of this technique were similar to the conventional technique. J Korean Ophthalmol Soc 2023;64(6):498-506