The Lumi-Indent: A novel illuminated scleral depressor and a comprehensive review of existing illuminated scleral depression techniques

Indian J Ophthalmol. 2025 Nov 1;73(11):1687-1690. doi: 10.4103/IJO.IJO_1245_25. Epub 2025 Oct 29.

ABSTRACT

Three-port pars plana vitrectomy (PPV) requires thorough visualization of the peripheral vitreous base, typically achieved using scleral depression. Traditional methods, involving either a trained assistant or chandelier illumination, are limited by cost, assistant dependency, and inconsistent visualization. In this article, we describe a “do it yourself”(DIY) cost-effective, improvised illuminated scleral depressor-“The Lumi-Indent”-created by inserting a 25-gauge endoilluminator into the cap of a disposable hypodermic needle and securing it with sterile tape. The device was used in 50 consecutive vitreoretinal surgeries with 360° vitreous base shaving. No intraoperative complications were noted. We also review existing techniques, including Veckeneer’s Tyndall effect-enhanced transillumination with triamcinolone and PFCL; Bamonte’s simplified method using a venflon cannula sleeve; Mandelcorn’s light pipe and finger-mounted ring depressor; Todorich’s digital heads-up system with a molded adapter tip; and Tan’s cotton swab-modified depressor. While each approach improves surgeon independence and peripheral visualization, many require either costly equipment or present structural limitations. Our Lumi-Indent depressor offered consistent illumination, scleral rigidity, and smooth conjunctival navigation, without the risk of bending or damaging the light pipe. Its negligible cost and simplicity make it an ideal solution for high-volume or resource-limited settings. In conclusion, the Lumi-Indent is a safe, frugal, and efficient tool for assistant-free vitreous base shaving, expanding the accessibility of advanced surgical techniques.

PMID:41148024 | DOI:10.4103/IJO.IJO_1245_25