Title/Título

SURGICAL MANAGEMENT OF RECURRENT RETINAL DETACHMENT

Short description of the case /Breve descrição do caso

This is the case of a 78 year old man who presented at the ophthalmologic emergency department complaining of progressive blurred vision in his left eye for the past 7 days. Best corrected visual acuity was 20/20 in right eye and 20/100 in left eye, he was pseudophakic both eyes at slit-lamp examination and presented normal intraocular pressure. At fundoscopy, a total rhegmatogenous retinal detachment could be observed in the left eye, with a inferior retinal tear. Pars plana vitrectomy + silicone oil (SO) was performed. 30 days after surgery, an inferior detachment due to PVR could be observed and macula was attached. Expectant management was decided until maturation of the membranes and Scleral buckle (SB) + pars plana vitrectomy + PVR Peeling was indicated after 30 days. Then SB was sutured, SO was removed and a fluid air exchange (FAX) was initially performed. Under air, Brilliant blue die was used to diffusely stain the internal limiting membrane. Perfluorocarbon Liquid (PFCL) was injected, and the membranes could be easily identified adjacent to the areas stained by the brilliant blue (negative staining), being removed with a retina forceps under PFCL. That is a safe technique for PVR removal, avoiding iatrogenic breaks. Peripheral PVR was also removed, not being necessary any retinectomy. FAX was done through a peripheral retinal break, with sub retinal fluid drainage and mild laser photocoagulation was done around the break and SO injected again, with good result.

Palavras Chave

Recurrent Retinal Detachment
PVR
Peeling under Perfluorocarbon

Area

SURGICAL RETINA