Transconjunctival drainage manages serous, hemorrhagic choroidal detachments
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FORT LAUDERDALE, Fla. — Transconjunctival drainage is an alternative technique for the management of both serous and hemorrhagic choroidal detachments, according to one surgeon.
“Most of the detachments are managed conservatively with mydriatics, cycloplegics and steroids, but surgical intervention may be needed when severe anterior chamber shallowing occurs, when vitreous or retinal incarceration is present, or when there is persistent decreased visual acuity or prolonged choroidal detachment,” Flavio Rezende, MD, PhD, said at the Retina World Congress.
In his transconjunctival technique, the infusion cannula is placed in the anterior chamber rather than in the pars plana, and the trocar is placed posteriorly, not in the pars plana, but 7 mm or 8 mm from the limbus at a 20° angle.
“If you drain in the pars plana, which we used to do with the 20 gauge, the trocar blade goes through the vitreous cavity and may hit the retina, causing damage,” he said.
This technique also allows more complete, instant drainage, and surgery does not take longer than 10 minutes.
“This technique was described without vitrectomy. It is only the drainage of choroidal detachment. Pars plana vitrectomy can be delayed to a later stage, when the choroidal detachment has resolved,” he said.
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Rezende F. Transconjunctival choroidal detachment drainage. Presented at: Retina World Congress; May 12-15, 2022; Fort Lauderdale, Fla.
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