En Bloc Resection of Retinal Capillary Hemangioma in Combined Tractional-Rhegmatogenous RD Repair

A 24-year-old woman was diagnosed with a combined tractional-rhegmatogenous retinal detachment (RD) associated with a retinal capillary hemangioma. We performed 23-gauge pars plana vitrectomy with chandelier endoillumination/intravitreal Kenalog/membrane peel/en bloc resection of tumor/air-fluid exchange/endolaser/injection of 1000 cS silicone oil. This video highlights techniques including bimanual feeder vessel ligation, excision of tumor that spanned retinal layers, and en bloc transscleral removal of lesion. Vision improved postoperatively from light perception to counting fingers. Retina remains attached under silicone oil. The patient's workup was negative for Von Hippel-Lindau syndrome.