A 70-year-old Female presented with gradual decrease in vision in right eye for last 8 months. On examination her BCVA in OD- CF 1 MT and OS- 6/9, N6. Both yes are pseudophakic. Fundus examination of OD showed large FTMH about 759 microns in size. A 25-gauze vitrectomy was done with PVD induction. Fluid air exchange is then performed and then we attempt to stain the internal limiting membrane with Brilliant Blue dye. And we meet with our first challenge of the case – a negatively stained Epi-Retinal Membrane which was not noted even on a routine Pre-Op OCT. Peeling is then initiated below the macula first and extended superiorly. While we try to peel the membrane around the macula and trim it with the vitreous cutter the whole of the membrane comes off and we are left with nothing to create an inverse flap as had been planned pre-operatively. Then a free-floating flap was grasped with ILM forcep and placed in FTMH and thus day is saved with difficulty.
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