Authors: Daniel Vilaplana, Vladimir Poposki, Isaac Alarcon, D. Martin, M. Castilla, Barcelona, Spain


A 65-year-old homeless man with hand movements vision in his left eye for a long period (the patient was unaware of this). He has been recently diagnosed with advanced diabetes mellitus. He suffered from high-risk proliferation with a chronic and haemorrhagic tractional retinal detachment and extensive preretinal haemorrage. This case was managed with vitrectomy using preretinal forceps to remove epiretinal fibrosis and performing drainage retinotomies to aspirate the blood with subretinal canulas. We propose our own procedure to obtein more satisfactory results in those difficult cases.


Our surgical technique consists of the following steps: Vitrectomy, epiretinal membranes extraction, drainage retinotomy to remove subretinal haemorrage, introduction of air to flatten the retina while we aspirate the subretinal fluids with microcanulas, perfluorocarbon liquid, intraocular laser photocoagulation, direct exchange of perfluorocarbon liquid with silicone oil 5000Cs.

Effectiveness / Safety:

Using this standarized technique, such cases could be managed with a high degree of effectiveness.

Take home message:

Following the proposed steps we can repair some difficult, advanced, proliferative diabetic retinopathy cases that otherwise would be impossible to improve.