Modification of the Suprachoroidal Buckling Technique for the Treatment of Rhegmatogenous Retinal Detachment

Supplemental Digital Content is Available in the Text.A modification of the suprachoroidal buckling technique for the treatment of rhegmatogenous retinal detachment using single-surgeon foot-pedal-controlled automated suprachoroidal injection of sodium hyaluronate 1% is presented here, which provides a more precise and potentially safer suprachroroidal buckling technique compared with the manual technique with more variable injection speed and pressure. Purpose:To describe modification of the suprachoroidal buckling technique for the treatment of rhegmatogenous retinal detachment (RRD), which may improve the safety profile.Methods:A single-surgeon foot-pedal-controlled automated suprachoroidal injection (SCI) of sodium hyaluronate 1%, namely ProVisc (Alcon Laboratories, Fort Worth, TX) was used for the treatment of RRD. MicroDose Injection Kit (MedOne Surgical, Sarasota, FL) including a connector and a 1-mL syringe, designed for subretinal injection, was used to adapt Constellation Vision System (Alcon Laboratories) console for SCI of ProVisc from the 1-mL syringe.Results:This approach enables better surgeon control during SCI. Three highly myopic eyes of three patients with primary macula-on RRD and single superior peripheral retinal break were treated. Complete retinal reattachment was achieved in all eyes without complications.Conclusion:Injecting ProVisc under foot-pedal control provides a more precise and potentially safer suprachoroidal buckling technique compared with the manual technique with more variable injection speed and pressure.