First Author: H.Trevino Rodriguez MEXICO
Co Author(s): J. Gonzalez Cortes C. Azuara Azuara M. De Alba Castilla E. Gutierrez Enriquez J. Ruiz Gonzalez J. Davila Villarreal
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To present possible intraoperative complications during internal limiting membrane removal (ILMR) in macular surgery (MS).
Departamento de Oftalmología. Hospital Universitario. Facultad de Medicina. UANL. Servicios Médicos Quirúrgicos de Monterrey, Monterrey, Nuevo Leon, México.
This is a retrospective video series where we assess the different intraoperative complications during ILMR in MS and the different clinical scenarios the patient and the surgeon may face. We show different surgeries performed at our surgical centre, performed by different experienced and training surgeons in macular cases.
Epiretinal haemorrhage is the most common complication observed during ILMR in MS. These tend to be small, auto-limited and without visual or clinical sequelae. However, in other cases, haemorrhages may be profuse and involve subretinal space, affecting the fovea and leading to visual damage secondary to photoreceptor toxicity and retinal atrophy. Not identifying structures, media opacity, and multifocal intraocular lens aberrations are the most common causes for impaired visualization of the macular structures leading to complications such as direct trauma to the retina, haemorrhages, intraretinal staining, and vascular avulsion during surgery.
Surgeons starting in macular surgery should be aware of the different possible complications they may face during ILMR in macular procedures. Although most intraoperative complications do not have visual implications, surgeons’ intraoperative stress must be controlled to avoid more complications and visual damage.