Divide-and-Conquer for Diabetic Tractional RD

-In this surgical video, Dr. Enchun Liu uses a "divide-and-conquer" technique to repair a macula-involving diabetic tractional retinal detachment (RD) with subfoveal fluid. He begins by using the vitrector probe to shave the peripheral vitreous cone. Then, using intraocular Shah forceps and the vitrectomy probe as a blunt dissecting instrument, the connected islands of fibrotic neovascular tissue are divided into smaller sections for easier removal. Removal of the peripheral hyaloid is critical, Dr. Liu explains, as it can act as a scaffold for reproliferation after surgery. The ILM is partially peeled to help delineate a dissection plane in the superior macula. Lastly, fill-in photocoagulation is given, followed by intravitreal bevacizumab and SF6 gas injection. The patient's visual acuity returned to 20/30 at 3-months post-surgery.

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