This patient had hand motion vision in her left eye from a closed funnel, combined with diabetic tractional and rhegmatogenous retinal detachment.
Along with vitrectomy, a 360-degree retinectomy was made anterior to the macula. The posterior retina was then flattened with Perfluoron, followed by silicone oil. A large macular hole was also noted intraoperatively.
This image was taken 1 week postoperatively and shows the extent of the retinectomy. Although intraoperatively we felt that we were excising full-thickness retina, once the retina flattened, a remaining outer layer of retina was variably present temporally and inferiorly.
Although Perfluoron is completely removed during surgery, complex cases such as this often have residual subretinal bubbles.
Functionally blind before surgery, she was able to fully care for herself in her apartment and use her microwave and cell phone at 1 week.
Learning Points:
Sometimes during vitrectomy, the only way to partially flatten the retina is to do a retinectomy to excise the extremely thick, stiff, and scarred retina anterior to the macula.
