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Bimanual Membrane Dissection Viewing Through a Wide-angle Viewing System in a Pediatric PVR Case

  Channels: Retina | Posted 8/22/2012

A 13-year-old boy underwent a 25-gauge vitrectomy with scleral buckling and crystalline lens removal for treating advanced proliferative vitreoretinopathy in the right eye. The intraoperative fundus findings viewed through a wide-angle viewing system (WAV) shows a total retinal detachment complicated with prominent fibrovascular membrane proliferation reaching the periphery. The tough and thickened cyclic membranes formed at the periphery are the most challenging to treat with a conventional single-hand technique. In contrast, bimanual manipulation viewing through the WAV under the chandelier endoillumination is a safe and practical technique for membrane removal. In this case, even the cyclic membranes at the periphery can be easily dissected and separated from the detached retina bimanually with a membrane forceps and scissors or a vitreous cutter. Bimanual manipulation in conjunction with the WAV and chandelier endoillumination is a critical and helpful technique for expanding the indications of small gauge vitrectomy to challenging cases.

Retina • Retinal detachment, RD • Small-gauge vitrectomy