Iatrogenic Macular Hole and Subretinal Migration of PFCL

File number: 108166

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By Aditya S Kelkar, MS, FRCS, FASRS,FRCOphth
NATIONAL INSTITUTE OF OPHTHALMOLOGY
Uploaded on Feb 7, 2023.
Last modified by Joshua Friedman on Feb 7, 2023.

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Appears in: Miscellaneous
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Description: The video demonstrates a surgical scenario where the fovea gives away by the force imparted by the jet of an injecting PFCL (Perfluorocarbon heavy Liquid) and the PFCL migrates subfoveally. Intraoperative OCT confirms the presence of a macular hole. The situation is managed by ILM peeling and mobilizing subfoveal PFCL peripherally by injecting another bubble of PFCL over the posterior pole. A peripheral drainage retinotomy is then created to aspirate the subretinal PFCL followed by fluid-air exchange, PFCL-air exchange, and endolaser around the retinotomy. Post-operative OCT at 3 weeks’ follow-up shows a sealed macular hole.