Edited Film

Rui Carvalho, Nuno Gomes, Filipe Isidro, Natalia Ferreira, Portugal

The authors present different surgical techniques during vitrectomy in several complicated or unusual cases (severe proliferative diabetic retinopathy, extraction of subretinal membranes, vitreoretinal proliferation, unknown double IOL dislocation into the vitreous cavity, among others). Sometimes the surgeon might hesitate and think: what should I do now? Dissection of fibrovascular membranes in cases of tractional or mixed retinal detachment associated with severe proliferative diabetic retinopathy and without any previous laser treatment can be extremely difficult to perform even with the arsenal of instrument and visualization systems available today. The presence or the induction of a retinal tear in such cases can be dramatic. Difficulty to control an intraoperative haemorrhage, even with previous antiVEGF treatment, might complicate the necessary manouvers to peel preretinal membranes and to reattach the retina. In cases of vitreoretinal proliferation, the choise of the local to perform a retinotomy in order to remove subretinal membranes is important to facilitate the manouver under the retina and to avoid other complications (like bleeding or enlargement of the retinectomy that might compromise the anatomical success). Dissection of vitreous base in anterior VRP is almost impossible without iatrogenic retinal tears. Even after a careful dissection and peeling of all pre and subretinal membranes, very large retinectomies can be required to reattach the retina fighting against retinal shrinkage. What to do when an unexpected second intraocular lens is luxated in vitreous cavity? If you want to suspend one of them, be sure to extract the right one first. Vitreoretinal surgery can be unpredictable and very challenging, particularly during some steps of difficult cases. Surgery sometimes feels like a vitreoretinal clash. Should I stay or should I go?…

Contact Details:

Rui Carvalho
Hospital de Pedro Hispano – Unidade de saude de Matosinhos
Cell Phone : 00351933266020
Work Phone : 00351933266020
Email : ruipacarvalho@gmail.com