AN UNUSUAL WAY TO INDUCE THE CLOSURE OF A POSTERIOR POLE RETINAL TEAR IN A TRAUMATIC RETINAL DETACHMENT

Abstract

The authors present a case of both traumatic subluxated lens with zonular dialysis and a traumatic retinal detachment with posterior retinal tear. Some fragments have dropped into the vitreous chamber during phaco-emulsification and one of them has even passed through the retinal tear and has been removed from the subretinal space. A 3-piece intraocular lens with a tension ring supporting the capsular bag was implanted. Pars plana vitrectomy with accurate vitreous base shaving was approached by 23-gauge system. Subretinal fluid was removed by a complete fluid-air exchange. A large macular internal limiting membrane (ILM) peeling was performed and the posterior retinal tear was covered by multiple inverted ILM flaps. Postoperatively, retinal reattachment was achieved, the retinal break was flat. The ILM flaps were well positioned within the retinal tear and covered the preoperatively bared RPE. The surgical treatment of injuries after a blunt ocular trauma are not standardizable. In this case surgical outcomes suggest the effectiveness of the surgeon’s intraoperative unusual maneuvers.