Comparison of Cryotherapy and Illuminated Endolaser Retinopexy in Chandelier-Assisted Scleral Buckling for Rhegmatogenous Retinal Detachment

Purpose: 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 (RRD). Methods: 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, while 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 (WAVS) by a single experienced vitreoretinal surgeon. Outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), swept-source OCT, and postoperative complications. Results: 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 occurred significantly more in Group 1 (19.3%) than in Group 2 (3.1%) (p=0.04). Rates of epiretinal membrane, cataract, and IOP elevation did not differ significantly (p>0.05). No buckle exposure or infection was observed. Conclusion: 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.