Abstract

80 year old patient presented with defective vision in left eye since 3 months. B scan shows vitreous haemorrhage with sub-retinal haemorrhage. 23G ports made and core vitrectomy done. Choroidal Neovascular Membrane (CNVM) with subretinal plaque is noted. An iatrogenic detachment is induced with 41 G needle. Fluid air exchange is done followed by diathermy to temporal periphery to create 180-degree retinal flap. The retinal flap is everted nasally using DDMS to expose the subretinal plaque. The plaque is removed using forceps and noted to be leathery. Diathermy is done to harvest temporal RPE graft. It is carefully positioned over macula and the retinal flap is reposited. The fibrotic plaque is buried temporally in the donor area of graft. PFCL and silicone oil topped up and advised supine positioning for 3 days. In a second stage surgery, silicone oil and PFCL are removed and fluid air exchange done. Endolaser is done at temporal aspect of flap along with silicone oil tamponade.