DR. YUSRA ASAD

, Dr. LALIT VERMA, Dr. AVNINDRA GUPTA, DR. RITESH NARULA

Abstract

To demonstrate formation of an iatrogenic tear as a potential complication in a vitreoretinal surgery and its management. A middle aged man, a week after undergoing a vitreoretinal surgery, revealed a recurrent retinal detachment with tractional membrane over the inferotemporal arcade. Intraoperatively, membrane dissection was initiated with attempted creation of an edge using microvitreoretinal blade. The rigidity of the underlying retina, its strong adherence to the membrane made this difficult. Diamond dusted scratcher, spatula and forceps used to attempt peeling but the force caused a tear in the retina adjacent to the attachment. Bimanual technique under PFCL was then employed for successful membrane removal. Fluid-air exchange, silicon oil reinjection and endolaser retinopexy completed with a resultant well attached retina. When dealing with strongly adherent membranes, always test traction before pulling on them. If not separating easily, shift to atraumatic ways of separation.