Tug of War with a Giant Retinal Tear

This is a case of a 360-degree giant retinal tear in a one-eyed ten-year-old boy. In young patients, the vitreous is extremely adherent to the retinal surface. Being a 360-degree giant retinal tear, the retina is totally mobile making it extremely difficult to remove this vitreous. PFCL heavy liquid also tends to overflow from the edges for this reason. A 25-gauge chandelier is inserted to allow bimanual surgery, with a massager in one hand to keep the mobile retina at bay while peeling the adherent vitreous with the cutter. This maneuver seems like a tug of war between the cutter and the giant retinal tear. With patience, we are able to detach this hyaloid and trim it to the minimum allowing the retina to flatten with PFCL. The retina has also rotated itself and we need to gently iron its folds and rotate it back to its normal position. After 360-degree endolaser is carried out to the edges of the tear, air-PFCL exchange is performed by keeping the edges of the tear dry to avoid slippage. In the end of the case, there is a complete flattening of the retina in the air-filled eye and silicon oil is injected as a postoperative tamponade.