Video Presentation

Surgical technique for inadvertent macular translocation after retinal detachment surgery

Video Details

First Author: D.Ruiz Casas SPAIN

Co Author(s):    F. Peralta Iturburu   M. Gomez Mariscal                          

Abstract Details



Purpose:

To describe a surgical technique for inadvertent macular translocation after retinal detachment surgery.

Setting:

Hospital Ramón y Cajal (Madrid), Spain

Methods:

A 55 year-old- man with history of retinal detachment surgery on his right eye (RE), was referred for metamorphopsia. The first surgery was performed 5 months earlier with phaco-vitrectomy, and sulfur hexafluoride (SF6) as a tamponade. At admission, best corrected visual acuity was 20/100 on RE. Fundoscopy showed inferior displacement of the macula with a extrafoveal fold. Pars plana 25G approach with ILM peeling, subfoveal Balanced-salt solution inyection through two 38g retinotomies. Tip of a backflush and perfluorocarbon liquid was used to massage the macula. Reapplication of the posterior pole with subretinal fluid (SRF) drainage through a superior retinotomy.

Results:

After 1 month the BCVA was 20/40 and metamorphopsia was reduced significantly showing a correct anatomical result in retinography and OCT. There was no evidence of the retinal fold and patient was satisfactory with the functional result. This postoperative complication used to be associated with inadvertent residual subretinal fluid (SRF) after the first surgery, also due to the lack of a properly head position after surgery that allows intraocular gas tamponade to keep applied the posterior pole.

Conclusions:

Inadvertent macular translocation is a rare complication after retinal detachment surgery. Patient frequent complaints are metamorphopsia and lack of visual acuity improvement after retinal detachment surgery. As the residual SRF reabsorbs, the redundant retina folds causing this anatomic alteration. This technique recovers the anatomical status with an optimal functional outcome restoring the correct place to the macula, preventing those visual symptoms that can be devastating for the patient. This technique appears to be an effective and safe option for the surgical management of this condition according to our outcome.

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