ImportanceIn-office suprachoroidal viscopexy (SCVEXY) is a relatively new procedure for rhegmatogenous retinal detachment (RRD), but minimal information is available regarding outcomes and safety.ObjectiveTo report outcomes with in-office SCVEXY for primary acute RRD.Design, Setting, and ParticipantsThis retrospective case series was conducted at St Michael’s Hospital in Toronto, Ontario, Canada from June 2023 to February 2024 among consecutive patients with primary acute RRDs who presented with retinal tears that were reachable with the current in-office SCVEXY technique in the temporal or nasal retina.ExposureSuprachoroidal injection of 0.6 mL of sodium hyaluronate, 2.3%, at the break location using a 30-gauge needle with a custom-made guard leaving 1 mm of the needle exposed. Laser retinopexy was applied around the break once reattachment was achieved.Main Outcome and MeasuresThe primary outcome was primary anatomic reattachment rate with SCVEXY and recovery of function and anatomic integrity.ResultsAmong 6 patients, 2 patients (33.3%) were female, and mean (SD) patient age was 52.5 (19.7) years. The final follow-up duration for each patient was 510, 420, 360, 360, 330, and 320 days, respectively. Baseline VAs were hand motions, counting fingers, 20/100, 20/100, 20/25, and hand motions for patients 1 through 6, respectively. A dome-shaped suprachoroidal buckle was present in all cases after the procedure. Five of 6 patients (83.3%) achieved anatomic reattachment with no retinal displacement or outer retinal folds, and these patients could resume normal activity immediately after the procedure with no restrictions. The mean (SD) logMAR VA at 3 months was +0.46 (0.34) (Snellen 20/57). The viscoelastic persisted in the suprachoroidal space as confirmed by multimodal imaging for 10, 14, 21, 13, 24, and 14 days, respectively, and the retina remained attached during the entire postoperative follow-up period. One patient’s SCVEXY failed due to inadequate viscoelastic at the posterior edge of the retinal break, and this patient underwent a successful pneumatic retinopexy. One patient developed a localized choroidal effusion unrelated to the SCVEXY site following laser retinopexy that resolved in 1 week associated with topical prednisolone, 1%, 4 times daily and cyclopentolate, 1%, twice daily.Conclusions and RelevanceIn this case series, the outcomes of these 6 cases suggest that SCVEXY may offer durable retinal reattachment in RRD. However, randomized clinical trial data, larger sample sizes, and longer-term follow-up are necessary to assess the risk-benefit profile of SCVEXY compared with the standard of care.

中文翻译：

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诊室脉络膜上内镜治疗急性孔源性视网膜脱离


重要性诊室脉络膜上视网膜脱离术 （SCVEXY） 是一种相对较新的孔源性视网膜脱离 （RRD） 手术，但关于结局和安全性的信息很少。目的报告诊内 SCVEXY 对原发性急性 RRD.Design、环境和参与者的结局本回顾性病例系列于 2023 年 6 月至 2024 年 2 月在加拿大安大略省多伦多市的圣迈克尔医院进行，在连续的原发性急性 RRD 患者中进行，这些患者的视网膜撕裂可通过目前的诊室 SCVEXY 技术在颞叶或鼻视网膜中触及。暴露使用带有定制防护装置的 0.6 号针头在断裂位置注射 0.6 mL 2.3 mL 透明质酸钠，使 1 毫米针头暴露在外。一旦实现重新连接，就会在断裂周围应用激光视网膜固定术。主要结局和测量主要结局是 SCVEXY 的主要解剖复位率以及功能和解剖完整性的恢复。结果6 例患者中，女性 2 例 （33.3%） ，患者平均 （SD） 年龄 52.5 （19.7） 岁。每位患者的最终随访持续时间分别为 510 、 420 、 360 、 360 、 330 和 320 天。基线 VAs 分别为患者 1 至 6 的手部动作、数手指、20/100、20/100、20/25 和手部动作。手术后所有病例均存在圆顶状脉络膜上扣带。6 例患者中有 5 例 （83.3%） 实现了解剖复位，没有视网膜移位或视网膜外皱襞，这些患者可以在手术后立即恢复正常活动，没有任何限制。3 个月时的平均 （SD） logMAR VA 为 +0.46 （0.34） （Snellen 20/57）。 多模态成像证实粘弹性分别在脉络膜上间隙持续存在 10 、 14 、 21 、 13 、 24 和 14 天，视网膜在整个术后随访期间保持附着。一名患者的 SCVEXY 由于视网膜裂孔后缘的粘弹性不足而失败，该患者成功接受了充气性视网膜固定术。1 例患者在激光视网膜固定术后出现与 SCVEXY 部位无关的局限性脉络膜积液，该积液在 1 周内消退，与局部泼尼松龙 （1%） 和 1% 环喷托酯 （1%） 每日 2 次相关。结论和相关性在本病例系列中，这 6 例病例的结果表明，SCVEXY 可能在 RRD 中提供持久的视网膜再连接。然而，随机临床试验数据、更大的样本量和长期随访对于评估 SCVEXY 与标准治疗相比的风险获益特征是必要的。