A Minimally Invasive Needle-Free Modified Cut-Down Technique for Posterior Sub-Tenon's Corticosteroid Injection

PURPOSE: To describe a minimally invasive needle-free modified cut-down technique for posterior sub-Tenon's corticosteroid injection that avoids blind orbital needle passage and is suitable for office-based retinal practice. METHODS: A stepwise surgical technique is described for posterior sub-Tenon's triamcinolone delivery using a 1-2 mm conjunctival incision, blunt dissection along the scleral surface, and flexible 27-gauge cannula-based injection. RESULTS: The technique was successfully implemented in an outpatient retinal clinic setting. In initial clinical use, no intraoperative complications were encountered, and the procedure was well tolerated. CONCLUSION: This modified needle-free cut-down technique provides a reproducible method for posterior sub-Tenon's corticosteroid delivery in outpatient retinal practice while eliminating blind orbital needle passage. It may provide a more controlled alternative to traditional techniques while potentially reducing the risks associated with blind sharp orbital needle passage.