Editors' Choice
    Posterior Segment Trauma, Retina/Vitreous, Vitreoretinal Surgery

    In this clinical video, Drs. Daniel Simhaee and Ajay Kuriyan demonstrate the use of a bimanual technique with intraoperative OCT in a man who developed a persistent macular hole after an assault 10 weeks prior. The surgeons recommended vitrectomy with free flap internal limiting membrane (ILM) placement into the macular hole, but the flap subsequently fell out of the hole despite numerous attempts to reposition it. The surgeons then decided to attempt a bimanual approach. Since the original flap could not be located, they peeled a new ILM flap and placed it in the hole. They then performed an air-fluid exchange with ILM forceps over the flap and a backflush over the nerve. Intraoperative OCT under air confirmed flap placement. The sclerotomies were sutured and the patient was treated with subconjunctival antibiotics and steroids.

    Relevant Financial Disclosures: None