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Yoreh Barak, MD, Lana Rifkin, MD, Maya Bitar, MD, Shlomit Schaal, MD, PhD
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Shlomit Schaal, MD, PhD; Yoreh Barak, MD; Maya Bitar, MD; and Lana Rifkin, MD; present the repair of a macular hole causing a macular retinal detachment using a sutureless 25G vitrectomy technique. A 43-year-old Caucasian female, with high myopia and a posterior staphyloma, presented with a macular hole and a retinal detachment extending to the temporal arcades. 25G trocars were inserted in a beveled manner. 25G vitrectomy was performed with 360 degree scleral depression. Intra-vitreal preservative free triamcinolone acetonide was injected. Subretina fluid was drained through the macular hole followed by air-fluid exchange. Perfluorocarbon heavy liquid was injected to flatten the posterior pole, and thereafter a posterior retinotomy was performed to drain residual subretinal fluid followed by 360 degree endolaser photocoagulation. At the end of the procedure, the retina was completely flat and the eye was filled with 25% SF6 gas.
Posted: 11/28/2012
Yoreh Barak, MD, Lana Rifkin, MD, Maya Bitar, MD, Shlomit Schaal, MD, PhD
Shlomit Schaal, MD, PhD; Yoreh Barak, MD; Maya Bitar, MD; and Lana Rifkin, MD; present the repair of a macular hole causing a macular retinal detachment using a sutureless 25G vitrectomy technique. A 43-year-old Caucasian female, with high myopia and a posterior staphyloma, presented with a macular hole and a retinal detachment extending to the temporal arcades. 25G trocars were inserted in a beveled manner. 25G vitrectomy was performed with 360 degree scleral depression. Intra-vitreal preservative free triamcinolone acetonide was injected. Subretina fluid was drained through the macular hole followed by air-fluid exchange. Perfluorocarbon heavy liquid was injected to flatten the posterior pole, and thereafter a posterior retinotomy was performed to drain residual subretinal fluid followed by 360 degree endolaser photocoagulation. At the end of the procedure, the retina was completely flat and the eye was filled with 25% SF6 gas.
Posted: 11/28/2012
![[2019] Amniotic Membrane Placement for Repair of Recurrent Macular Hole](https://d33x7gwyb2b5z6.cloudfront.net/eyetube/thumbs/gldaw.jpg?auto=compress,format&w=180)
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Just Now
Shlomit Schaal
12 years ago
Good comments, thank you. PVD was of-course performed prior to FAX, you are right. We cut this part out to keep the video short, but I absolutely agree with you - we should have left it in. For the second comment: I felt uncomfortable draining the fluid out of the macular hole itself, because of the fear of enlarging the hole and creating more photoreceptor damage in the foveas area. There was a large amount of subretinal fluid that had to be drained. I am not a fan of retinotomies - but in this case I felt it was necessary. PFCL was used to make sure all fluid is pushed out from the area of the posterior staphyloma. Thank you for watching and for discussing this case.
neeraj pandey
12 years ago
2 comments, why PVD trial is not seen after putting TA in, rather we can see direct FAX. and what was the need for PFCL and extra retinotomy when fluid could be drained through macular hole itself with FAX itself. and rest gas would do.