Utilization of Intracameral Viscoelastic Injection for the Management of Concurrent Choroidal and Retinal Detachment...

The purpose of this report is to document a technique involving anterior chamber viscoelastic injections to address a serous choroidal detachment in the setting of a concurrent rhegmatogenous retinal detachment to improve surgical conditions.

A thorough chart review was performed on the patient in addition to a comprehensive literature review utilizing PubMed to gather current data on the treatment of combined choroidal and retinal detachments.

A 72-year-old male presented with advanced glaucoma and high intraocular pressure (IOP). The patient's elevated IOP was refractory to maximum topical medical management; consequently, he underwent non-valved glaucoma drainage device (GDD) surgery. His recovery was complicated by chronic hypotony which led to the development of a combined choroidal and retinal detachment. Our team injected sodium chondroitin and sodium hyaluronate in the anterior chamber of the eye, which successfully alleviated the serous choroidal detachment prior to pars plana vitrectomy (PPV). The patient did not require any further retinal interventions for the 2 years of follow-up. His IOP has remained normal in the high single digits on three glaucoma agents with the tube still tied off permanently with 6-0 nylon. His visual acuity returned to baseline (20/200) after 6 weeks.

This case demonstrates that intracameral viscoelastic injections prior to PPV can be utilized as rescue therapy to treat serous choroidal detachment in the setting of a rhegmatogenous retinal detachment in patients with GDD surgery to improve surgical conditions prior to retinal detachment repair.