FEB 28, 2023
AAO 2022 Video Program
Retina/Vitreous, Vitreoretinal Surgery
This video presents a successful case of retinal hemangioblastoma (RH) endoresection without suture ligation of feeder vessels. A 21-year-old man with von Hippel-Lindau syndrome presented with a 5 × 2-mm RH and surrounding exudative retinal detachment (RD). At 1 month after transscleral cryotherapy, RD with proliferative vitreoretinopathy (PVR) progressed. A 25-gauge vitrectomy was performed, with complete removal of posterior hyaloid. Diathermy to feeding vessels was performed, and RH was carefully dissected with endoscissors and externalized through a widened sclerotomy site using a handshake technique. Retinopexy was applied to the region of the retinectomy, with silicone oil tamponade. Scleral encircling was performed to support the peripheral retina. The pathological diagnosis confirmed RH. Exudation resolved without postoperative complications. Important points to consider during vitrectomy include effective closure of feeder and draining vessels by diathermy to feeding vessels under high intraocular pressure, as well as complete removal of posterior hyaloid and epiretinal membranes to avoid postoperative vitreous hemorrhage and PVR.
Financial Disclosures: Dr. Tarek Alasil and Seung Min Lee disclose no financial relationships.