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Suprachoroidal buckling.

Ehab N El Rayes1

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A novel suprachoroidal buckling procedure using a specialized catheter and filler effectively treats retinal detachment, including myopic macular holes and peripheral breaks. This minimally invasive technique offers a safe and feasible alternative surgical option for various retinal conditions.

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Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Vitreoretinal Diseases

Background:

  • Retinal detachment poses a significant threat to vision.
  • Current treatments for retinal detachment, such as vitrectomy and episcleral buckling, have limitations.
  • Myopic macular pathologies and peripheral retinal breaks present unique surgical challenges.

Purpose of the Study:

  • To assess the feasibility of a new suprachoroidal buckling procedure for retinal detachment.
  • To evaluate the efficacy of suprachoroidal indentation using a novel filler for various retinal conditions.
  • To explore the potential of this technique in managing myopic traction maculopathy, macular holes, and peripheral retinal breaks.

Main Methods:

  • A suprachoroidal catheter/cannula was used to access the subretinal space.
  • A long-lasting hyaluronic acid filler was injected to create a suprachoroidal buckle.
  • The technique was applied to central myopic macular holes and peripheral retinal breaks, alone or with vitrectomy.

Main Results:

  • Successful retinal layer restoration in all myopic foveoschisis cases.
  • 83% closure rate for myopic macular hole detachment, with 66.6% visual acuity improvement.
  • All peripheral retinal breaks were adequately buckled and closed in a single procedure.
  • The suprachoroidal buckle provided sufficient support and remained effective over 24 months.
  • The procedure demonstrated safety and simplicity in application.

Conclusions:

  • Suprachoroidal buckling is a feasible method for managing myopic foveoschisis and macular hole detachment, even after failed vitrectomy.
  • This technique effectively treats peripheral retinal tears and selected retinal detachments, including subsilicone inferior recurrent retinal detachment.
  • It offers a valuable addition to surgical options, potentially avoiding complications associated with traditional methods.