A simple technique for suprachoroidal space injection of triamcinolone acetonide in treatment of macular edema.

Aim: To introduce a simple resistance controlled suprachoroidal space (SCS) injection technique using a disposable 30-gauge needle connected to a 1 mL syringe and evaluate the effectiveness and applicability of this technique in the treatment of macular edema.

Methods: A total of 20 patients with various types of macular edema were subjected to a resistance controlled SCS injection of triamcinolone acetonide (TA) with a disposable 30-gauge needle connected to a 1 mL syringe. This technique allows the easy and smooth injection of the TA only once the tip of the needle reached the potential SCS which was indicated by the lower resistance on the plunger. The main outcome measures were anterior segment spectral-domain optical coherence tomography (AS-OCT) measurements post-operation immediately and central subfield thickness (CST), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) measurements at 3mo post-operation.

Results: AS-OCT examination showed the expansion of the SCS near the injection site immediately after SCS injection. At three months of follow-up, as compared to the baseline, the mean CST was significantly decreased from 535.0±157.24 to 319.55±127.30 µm (<0.001), the mean BCVA was significantly improved from 1.05±0.41 to 0.73±0.41 logMAR (<0.001), and the mean IOP was not significantly different, from 15.05±2.54 to 15.85±3.60 mm Hg (=0.185). Any complication related to the injection procedure including cataract, choroidal and retinal hemorrhage, retinal detachment, or endophthalmitis was not observed in this study.

Conclusion: The simple and minimally invasive technique of SCS injection of TA with a disposable 30-gauge needle connected to a 1 mL syringe is useful and applicable for macular edema.