Diabetic Tractional Retinal Detachment Repair and Internal Limiting Membrane Peel

Dr. Enchun Liu treats a 54-year-old woman with diabetes who presented with bilateral hand motion vision due to severe chronic tractional retinal detachments in both eyes. Starting with the previously better-seeing eye, Dr. Liu first performs a core vitrectomy and then shaves the peripheral vitreous cone to relieve AP traction and release fibrotic tissue. A vitrectomy probe is placed along the dissection plane underneath the main bridging band of fibrosis and segmented to relieve tangential traction. ILM is peeled over detached retina using frequent regrasping and redirecting of the force vector so as to not peel against the fovea. The procedure ends with a drainage retinotomy due to the amount of thick posterior subretinal fluid, which would otherwise take at least several months to resolve on its own after the traction was removed. The patient improved to BCVA 20/70 at 3 months after surgery with a reattached retina.

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