Induction of Choroidal Detachment: A New Surgical Technique for Choroidal Biopsy

Abstract

Abstract: : Purpose: To demonstrate a new surgical technique for choroidal biopsy. Methods: A standard 3–port pars plana vitrectomy is performed. A vitreous biopsy is obtained at the start of the procedure. The selected area of biopsy is surrounded with diode laser to close choroidal vessels. The subretinal cannula (32 G) is now introduced at the level of subretinal space and a localised retinal detachment is created with balanced salt solution.. Following this, the cannula is placed in the suprachoroidal space and the balanced salt solution is slowly injected. The blister like appearance at the injection site is related to induced choroidal detachment. Vertical cutting scissors is then introduced; and in turn the retinal and choroidal tissue is cut . Intraocular forceps are then used to grasp the excised tissue. Fluid/gas exchange is performed at the end. Results: The induction of the choroidal detachment allows easy and controlled access to a wider area for excision. Conclusions: Our technique makes the process of retino–choroidal biopsy very simple and easy to perform. The risk of intraocular haemorrhage from the biopsy site is less and the tissue damage during manipulation is avoided.

Keywords: choroid • vitreoretinal surgery • cytology