Pneumatic Retinopexy Rescue with In-Office Suprachoroidal Viscopexy

To describe in-office suprachoroidal viscopexy (SCVEXY) as a novel adjunct surgical technique with pneumatic retinopexy (PnR) for rhegmatogenous retinal detachment (RRD).

A 61-year-old pseudophakic man who was failing PnR for a macula-involving RRD underwent rescue SCVEXY at St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.

An injection of suprachoroidal sodium hyaluronate 2.3% (Healon 5, Johnson & Johnson Vision) was performed at five o'clock under the causative retinal tear using a 30 G needle with a custom-made guard that exposed 1 mm of the needle. Following the procedure, a dome-shaped suprachoroidal convexity was present in the inferotemporal quadrant. The patient achieved complete reattachment over 2 days with continued positioning. Laser retinopexy was applied around the causative tear, and the viscoelastic reabsorbed over a period of approximately 2 weeks. The retina remained attached until the final follow-up at 9 months.

Suprachoroidal viscopexy (SCVEXY) is a minimally invasive in-office procedure that creates a temporary suprachoroidal buckle that can be used to rescue failing PnR in RRD. It can be particularly useful to close inferior tears, avoiding the need for operating room procedures such as pars plana vitrectomy or scleral buckle. However, there are still limited data on ideal case selection, efficacy, adverse events, and failure rates.