Abstract
PURPOSE: To determine the functional outcomes of chandelier-assisted scleral buckling (CSB) in rhegmatogenous retinal detachment (RRD) and compare them to standard scleral buckling (SSB). METHODS: A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Searches were performed in PubMed, Scopus, Web of Knowledge, and Embase up to March 2024. Studies reporting functional outcomes, particularly best-corrected visual acuity (BCVA), after CSB were included. Risk of bias was assessed using standardized tools. Meta-analysis were conducted for BCVA improvement, change in BCVA (ΔBCVA), and operation time. Publication bias and heterogeneity were evaluated using funnel plots, Egger's test, and I (2) statistics. RESULTS: A total of 27 studies were analyzed. Meta-analysis of 1258 eyes revealed significant BCVA improvement postoperatively (mean difference [MD]: -0.51; 95% confidence interval [CI]: -0.64 to -0.38; P < 0.001). Comparative analyses of six studies showed no significant difference in ΔBCVA or anatomical outcomes between CSB and SSB, but operation time was significantly shorter for CSB (MD: -18.87 min; 95% CI: -22.70 to -15.3; P < 0.001). Meta-regression identified macular detachment and preoperative BCVA as the only factors significantly associated with postoperative visual outcomes. CONCLUSIONS: CSB significantly improves BCVA and offers comparable functional and anatomical outcomes to SSB while reducing surgical duration. This approach mitigates the limitations of traditional scleral buckling, making it a viable and efficient option for managing RRD.