, Dr. MAHESH P. SHANMUGAM, Dr. RAJESH RAMANJULU, Dr. DIVYANSH MISHRA
Abstract
Despite thorough pre-operative examination and intra-operative indentation, break localisation often remains an enigma. On several occasions the tiny rhegma remains obscure necessitating superfluous steps like 360 degree endolaser. Sub-retinal injection of Trypan Blue has been described for intra-operative identification of occult retinal breaks. However, Trypan Blue has been proven to be retinotoxic in the sub-retinal space. Moreover, trans-retinal injection entails the creation of an additional unnecessary retinotomy, even though self-sealing. To overcome these limitations, we demonstrate the trans-scleral injection of diluted Brilliant Blue G into the sub-retinal space. Thereafter, the plume of dye leaking into the vitreous cavity helps to localise the break. Heavy perfluorocarbon can be injected into the vitreous cavity to expedite egress of the dye, though this may not always be necessary. After break localisation, surgery is completed as per the usual steps.
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