Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Acknowledgements
Authors’ reply
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Clinicopathological Conference
Conferences
Correspondence
Corrigendum
Editorial
Eminent Indians in Medicine
Errata
Erratum
Everyday Practice
Film Review
History of Medicine
HOW TO DO IT
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter from Mangalore
Letter From Mumbai
Letter From Nepal
Masala
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Notices
Obituaries
Obituary
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
Students@nmji
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Acknowledgements
Authors’ reply
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Clinicopathological Conference
Conferences
Correspondence
Corrigendum
Editorial
Eminent Indians in Medicine
Errata
Erratum
Everyday Practice
Film Review
History of Medicine
HOW TO DO IT
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter from Mangalore
Letter From Mumbai
Letter From Nepal
Masala
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Notices
Obituaries
Obituary
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
Students@nmji
View/Download PDF

Translate this page into:

Images in Medicine
36 (
6
); 398-398
doi:
10.25259/NMJI_1030_2022

Do-it-yourself chandelier illumination

Dr R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

[To cite: Venkatesh P, Bhayana AA, Azad SV. Do-it-yourself chandelier illumination. Natl Med J India 2024;37:398. DOI: 10.25259/NMJI_1030_2022]

During pars plana vitrectomy, bimanual manoeuvres could be invaluable in some complicated surgeries, e.g. dissection of diffuse and firmly adherent membranes in proliferative retinopathies; removal of deeply impacted retained intraocular foreign body and often in the management of giant retinal tear-associated retinal detachment. Visualization using chandelier endo-illumination (CE) is a boon during these bimanual interventions.1,2 CE is also critical to performing surgeries such as endo-illumination-assisted scleral buckling surgery and obtaining intraocular tissue samples by fine-needle aspiration biopsy. However, a chandelier light source may not be easily accessible in resource-constrained low- and middle-income countries, due to the additional cost of about US$100. To overcome this limitation, we devised a do-it-yourself (DIY) method to create a‘bimanual light source buddy’. We used a routine 27-gauge vitrectomy fibreoptic illumination probe (Constellation® vision system, ALCON) (which is discarded after surgery) and cut off its main handpiece using a wire cutter. Then, a small segment (about 4 mm) of the overlying sleeve, that encases the fibreoptic, was teased away using the wire cutter (Fig. 1a). The fibreoptic that was so exposed (Fig. 1b) inserted easily into a normal 23-gauge vitrectomy cannula (Fig. 1c). An improvised DIY chandelier source was created in an office setting. After adequate sterilization, it was tested during actual vitreous surgery and found to provide adequate visualization. Our innovation is a modification of an already in-use US Food and Drugs Administration approved endo-illumination system for vitrectomy and is hence biologically safe.35 It does not cause thermal injury at the application site as it is physically isolated from biological tissue with a 23-gauge cannula, into which it fits snugly. This provides the same stability as is provided by the original self-retaining chandelier light source.

(a) Fibreoptic with overlying sleeve removed; (b) illumination tested; (c) insertion into cannula
FIG 1.
(a) Fibreoptic with overlying sleeve removed; (b) illumination tested; (c) insertion into cannula

References

  1. , , , , , . Bimanual 25-gauge chandelier technique for direct perfluorocarbon liquid-silicone oil exchange in retinal detachments associated with giant retinal tear. Indian J Ophthalmol. 2018;66:1849-51.
    [CrossRef] [PubMed] [Google Scholar]
  2. , . Trimanual vitrectomy for severe proliferative diabetic retinopathy. Int Ophthalmol. 2021;41:1717-27.
    [CrossRef] [PubMed] [Google Scholar]
  3. . Silicone oil in vitreoretinal surgery. Dordrecht. Netherlands: Martinus Nijhoff/Dr. W. Junk Publishers;
    [Google Scholar]
  4. , , , . Grössere Sklerotomien für den Einsatz des multiportalen Illuminations systems erhöhen nicht das Komplikationsrisiko einer Vitrektomie [Larger sclerotomies for use of the multiport illumination system do not increase the complication risk of vitrectomy] Klin Monbl Augenheilkd. 1995;206:78-82.
    [CrossRef] [PubMed] [Google Scholar]
  5. . Twin lights: A new chandelier illumination for bimanual surgery. Retina. 2003;23:893-4.
    [CrossRef] [PubMed] [Google Scholar]

Fulltext Views
355

PDF downloads
270
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections