AAO2021 Video Program

    A 70-year-old woman presented urgently due to vision loss to light perception in the right eye. Notable past history included type 2 diabetes, hyperlipidemia and hypertension. She had wet AMD and was treated with four anti-VEGF monthly injections for limited subretinal hemorrhage and active CNV. Meds included 81 mg ASA but no other AC therapy. Exam showed advanced cataract and bullous hemorrhagic retinal detachment without breaks. The patient elected surgical intervention despite a very guarded prognosis. Cataract surgery and elevating the posterior hyaloid were followed by a meticulous peripheral 23-gauge pars plana vitrectomy, a 180-degree peripheral retinectomy and removal of massive clotted heme along with the choroidal neovascular membrane. The retina was reattached with perfluoro-n-octane, endolaser was applied and 5000 cs silicone was injected. The cannulas were removed and the sclerotomies closed. The patient is seeing CF @ 5 feet at the postoperative Month 2 visit.