Author’s Disclosure Block: Aurora Pecaku, none; Isabela Matins Melo, none; Rajeev Muni, Silber Target Fund

Abstract Body
Purpose: To report the primary anatomic reattachment rate with pars plana vitrectomy-suprachoroidal viscopexy (VIT–SCVEXY) for rhegmatogenous retinal detachment (RRD) repair. Secondary outcomes included Snellen's visual acuity (VA) at postoperative month 3 and final follow-up. Furthermore, any adverse events were also documented and reported.Design: Retrospective cohort study. Methods: Patients diagnosed with RRD and inferior breaks and referred to St. Michael’s Hospital, Unity Health Toronto, from 2023 to 2024 who underwent PPV-SCVEXY. Ethics approval and informed consent were obtained, and the study adhered to the Declaration of Helsinki.Intraoperative suprachoroidal viscopexy (SCVEXY) was performed under sub-Tenon anesthesia after a 23-gauge vitrectomy, air-fluid exchange and laser retinopexy following the protocol by Muni et al. (2023). 0.6 cc sodium hyaluronate 2.3% (Healon 5, Johnsons and Johnsons) was delivered into the suprachoroidal space using a 30-gauge needle with a custom guard exposing 1 mm of the needle tip. Results: Eleven consecutive patients diagnosed with RRD were included in this study. The mean age of the cohort was 62.3 ± 12.4 years old, and 54.5% of patients (6/11) were male. Among all patients, 72.7% (8/11) were phakic. Regarding baseline clinical RRD characteristics, 45.5% (5/11) of cases were primary detachments, while 54.5% (6/11) were failed pneumatic retinopexy cases. Additionally, 72.7% (8/11) were fovea-involving RRDs. Mean LogMAR best-corrected VA (BCVA) was 1.55 ± 0.99 (Snellen equivalent 20/700) at presentation. All patients had visible or presumed inferior breaks. 2 patients had PVR stage C. Mean follow-up time was 7.9 ± 3.9 months.A suprachoroidal bleb of viscoelastic was successfully created in 72.7% (8/11) of cases. Two RRDs where the suprachoroidal bleb was not successfully created had vitrectomy and one case underwent combined Vit buckle. The primary reattachment rate at 3 months follow-up in those who had a successful suprachoroidal bleb was 100% (8/8), with a mean LogMAR BCVA of 0.75 ± 0.25 (Snellen equivalent 20/100). Only one patient treated with vit-SCVEXY experienced a re-detachment due to inferior PVR at postoperative month 5. The only adverse effect observed was significant chemosis on the first postoperative day, affecting 27.3% (3/11) of patients. At their last follow-up, 87.5% (7/8) of patients remained attached. Conclusions: Combined with vitrectomy, SCVEXY may provide supplementary support for inferior retinal breaks with potentially fewer adverse effects and a less invasive procedure than a traditional supplementary buckle. The potential ability of SCVEXY to improve reattachment rates in patients with inferior breaks may represent a significant potential advancement in RRD management.