Injection intra-vitréenne de produit viscoélastique pour la gestion des décollements choroïdiens associés aux décollements de rétines

Abstract

Combined retinal detachment and choroidal detachment (RDCD) is a serious type of retinal detachment occurring mainly in high myopes, which poses many pre-, intra- and postoperative difficulties that can affect the visual prognosis. Personal technique used in 8 patients with RDCD, consisting of intravitreal injection (IVI) of a viscoelastic (VE) device 2 to 3 days prior to vitrectomy. Reattachment of the choroid in all patients, with return to normal IOP, allowing vitrectomy to be performed under optimal conditions. RDCD often occurs in high myopia, especially in the case of an associated giant tear, the mechanism of which involves severe hypotony, resulting in a vicious cycle including development of the choroidal detachment (CD), partial retinal reattachment, normalization of the IOP, redetachment of the retina, and once again, hypotony. Preoperative viscoelastic IVI can break this vicious cycle and reattach the choroid, often within 24 to 48hours. This thus facilitates RD surgery without the intra- and postoperative technical difficulty of managing the CD. Viscoelastic IVI is a simple, safe, inexpensive and reproducible technique for the treatment of CD associated with RD in order to prepare for RD surgery under the usual conditions without a CD.