An Unappealing Case of Unpeeling Posterior PVR

Dr. R. Rishi Gupta tackles a grade C proliferative vitreoretinopathy (PVR) "starfold" in the macula of a patient with chronic macula-off retinal detachment. Demonstrating careful peeling of internal limiting membrane and pre-retinal PVR membranes, he offers pearls for the effective removal of the ILM on a detached retina—which is much more mobile than one that is attached—including the use of a variety of instruments and, at times, a bimanual approach.

Financial Disclosures: Dr. R. Rishi Gupta discloses financial relationships with Allergan, Apellis Pharmaceuticals, Bayer Healthcare Pharmaceuticals, Biogen MA, Hoffman La Roche, Johnson & Johnson Vision, Novartis Pharma AG (Consultant/Advisor).