Intravitreal viscoelastic injection for management of combined choroidal and retinal detachments

Introduction. - Combined retinal detachment and choroidal detachment (RDCD) is a serious type of retinal detachment occurring mainly in high myopes, which poses many pre-, intra- and postoperative difficulties that can affect the visual prognosis. Material and methods. - Personal technique used in 8 patients with RDCD, consisting of intravitreal injection (IVI) of a viscoelastic (VE) device 2 to 3 days prior to vitrectomy. Results. - Reattachment of the choroid in all patients, with return to normal 10P, allowing vitrectomy to be performed under optimal conditions. Discussion. - RDCD often occurs in high myopia, especially in the case of an associated giant tear, the mechanism of which involves severe hypotony, resulting in a vicious cycle including development of the choroidal detachment (CD), partial retinal reattachment, normalization of the 10P, redetachment of the retina, and once again, hypotony. Preoperative viscoelastic IVI can break this vicious cycle and reattach the choroid, often within 24 to 48 hours. This thus facilitates RD surgery without the intra- and postoperative technical difficulty of managing the CD. Conclusion. - Viscoelastic IVI is a simple, safe, inexpensive and reproducible technique for the treatment of CD associated with RD in order to prepare for RD surgery under the usual conditions without a CD. (C) 2021 Elsevier Masson SAS. All rights reserved.

Automated summary

RDCD is a serious condition in high myopes, and injecting viscoelastic gel preoperatively can efficiently break the vicious cycle, reattach the choroid quickly, and facilitate RD surgery under optimal conditions.