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Updated: Apr 24, 2026

Implantation Protocol of the Foldable Capsular Vitreous Body for Complex Vitreoretinal Surgery

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Preoperative Intravitreal Viscoelastic Injection (PIVOT) for Surgical Optimization in Rhegmatogenous Retinal

Ritweez Sahu¹, Devesh Kumawat¹, Ananya Kaginalkar¹

¹Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Ophthalmic Surgery, Lasers & Imaging Retina

|April 22, 2026

Summary

This summary is machine-generated.

Preoperative intravitreal viscoelastic injection (PIVOT) effectively reduces choroidal detachment height before vitrectomy for rhegmatogenous retinal detachment with choroidal detachment (RRDCD). This safe procedure optimizes surgical conditions for complex retinal detachments.

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Intraoperative Visualization of Subretinal Injection and Retinal Detachment in Rats

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Published on: March 7, 2025

Area of Science:

Ophthalmology
Retinal Surgery
Vitreoretinal Interface

Background:

Rhegmatogenous retinal detachment with choroidal detachment (RRDCD) presents significant surgical challenges.
Effective management strategies for RRDCD are crucial for successful visual outcomes.

Purpose of the Study:

To evaluate the safety and efficacy of preoperative intravitreal viscoelastic injection (PIVOT) in facilitating vitrectomy for RRDCD.
To assess the impact of PIVOT on intraocular pressure and choroidal detachment height.

Main Methods:

A consecutive series of eight eyes with RRDCD underwent PIVOT using Healon™ PRO (1% sodium hyaluronate) prior to vitrectomy.
Concurrent treatment included topical difluprednate, cycloplegics, and oral corticosteroids.
Outcome measures included intraocular pressure (IOP), cumulative choroidal detachment (CD) height, and adverse events.

Main Results:

Mean IOP increased significantly from baseline (4.75 ± 2.05 mmHg) to the day of surgery (10.0 ± 3.34 mmHg) (P = .001).
Cumulative CD height significantly reduced from 15.82 ± 4.88 mm to 5.49 ± 6.01 mm (P = .003).
No injection-related adverse events or intraoperative complications were reported; vitrectomy was completed successfully.

Conclusions:

PIVOT, in conjunction with anti-inflammatory therapy, demonstrates safety and efficacy in managing RRDCD.
This approach optimizes surgical conditions, facilitating successful vitrectomy in complex retinal detachment cases.