External Drainage of Stage 3B Coats Disease Total Retinal Detachment

In this surgical video, Drs. Jessica Lee and Richard Kaplan use external drainage to manage a total retinal detachment in a patient with Coats disease. The patient was a 31-month-old boy who presented with strabismus, a total retinal detachment and telangiectatic retinal blood vessels which leaked on fluorescein angiogram—features that are consistent with Coats disease. She uses a blade to incise the sclera to the choroid level and drains the subretinal fluid. Cryopexy was applied to telangiectatic vessels, and balanced salt solution was used to maintain IOP. An intravitreal bevacizumab injection was administered at the end of surgery. At postop month 4, there is sustained flattening of the retina. 

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