Channels: Retina | Posted 6/27/2011
For this surgery, Martin Charles, MD, employed MIVS using the 23-gauge valved entry system. First, a complete core vitrectomy was performed to address the vitreous hemorrhage, after which retina dialysis and a retinal tear were visible. Aspiration was used to completely detach the posterior hyaloids and injected perfluorocarbon liquid to stabilize the posterior pole and the vitreous base was shaved 360º using the CONSTELLATION shave mode. A 23-gauge DSP serrated forceps tip was used to remove the retroretinal membranes. Coagulation of the bleeding vessels was achieved with endodiathermy. A retinectomy was performed with the 23-gauge vitrectomy probe and endodiathermy was used to demarcate the retina for a posterior retinectomy. The surgeon drained the subretinal fluid with the aspiration cannula while performing a fluid/air exchange with drainage of the subretinal fluid under perfluorocarbon on the posterior pole. Using the Alcon Illuminated Flexible Curved Laser Probe, photocoagulation was performed through the 23-gauge incision. The last step of the surgery was to inject silicone oil into the eye using the venting valve on the valved entry system probe tip for photocoagulation, which vents the air as the silicone oil enters the eye and prevents IOP spikes. The cannulas were then removed from the eye at the end of the case without the need for sclerotomy sutures. The postoperative fundus photos show an attached retina with progressive resolution of the hemorrhage in the upper left-hand quadrant.