Well, this is a case that [00:00:10.

08] and a crater found in the incision is that with our limbus parietally,
and this [00:00:22.12] for all silica filled suture without isolating the muscles. And then I insert a 27-
gauge valved trocar and both location and right in the hole and then also I perform a [00:00:40.00] for
the calculation with the endo-illumination under there with the [00:00:45.29] assistant. And so, kind of
spongy, suture and tighten as usual. And then thin as a sac suture and the [00:00:59.19] sutured
separately.

So, Manish I think a while back you showed us, I think it was a few years ago when you started doing
scrub buckled under chandelier lighting. I think now people are getting more and more aggressive with
doing intravitreal procedures while doing a buckle. Do you do endo laser?

No, I, I just stick to the classic buckling along with just visualization inside to look at everything with a
chandelier. But I've not added any procedures internally to the classic buckling where that goes.

David, do you do any endo laser with buckling procedure or do you chandelier light for,

I do chandelier buckles but I do exactly as Manish said. I showed a video earlier today I was like it's cryo,
it's drainage with the chandelier.

Just cause would add the laser to sclera that old for the choroidals.

So, did you do in the eye or was it done from the outside?

From outside of the eye.

So, I have also seen videos where people go inside the eye, use the endo-illuminator actually to localize
things also and I think the interesting component is, when you talk to the classic bucklers, they get a
cringe when they see the chandelier light because the main point of doing the scleral buckle was not to
invade the vitreous cavity and not to go into the eye. And then we also had seen a few videos where you
get retinal tears or detachments from the area of the chandelier light. So, chandelier is obviously for
those of you who d training with the fellows or even just for visualization. Makes everything a lot easier.
But again, you got to pay real attention to make sure there are no breaks into that area. One of the
disadvantages of using a chandelier is that we do not have valved trocars for the chandelier light. So that
you can prevent vitreous prolapse. But one of the things you want to do is, once you are done, make
sure that you re-evaluate the area of chandelier light to make sure there are no peripheral breaks of
traction in that area. And again, you want to try to avoid doing laser or endo-illumination because that is
supposed to be an extra vitreal procedure.