Main Complaint:

Patient presented with slow vision loss in left eye with cortical cataract with chronic vitreous floaters.

Medical History:

JIA with long term prednisone, methotrexate and plasmaquine treatment.

Recurrent pan-uveitis with prominent floaters treated with sub-tenon 4mg Triamcinolone.


Surgical: Phaco and IOL: Complicated with anterior capsule tear.

23G PPV with intraoperative difficult traumatic posterior vitreous    detachment with nerve/vein damage.

Medical : 700ug dexamethasone intravitreal implant.


Photos and video showing the complications and discussing the lessons learned.

  1. The radial tear, prevention and management
  2. Managing difficult PVD induction, having a back-up plan
  3. Dealing with poor patient outcome and with the doctor’s disappointment


Be prudent in proceeding with the second part of the procedure after experiencing unexpected complications.



Gabriel de Vos de la Bat
Private Practice Kloofeye Curedayclinic Erasmuskloof
Pretoria, South Africa
Email: riel@kloofeye.co.za
Work Phone: +27123470500