Dr.Bhavik Panchal

Dr.Subhadra Jalali, Dr.Tapas Padhi

Abstract

A 5-month child presented with BE stage 5 ROP – closed funnel RD.
The child underwent a pars plana lensectomy with vitrectomy.
A bimanual surgical approach was followed. Anterior chamber infusion was used. Bimanual surgery was performed using curved vitreous scissors and pic forceps.
Dissection was initiated using a sharp trochar and an opening in the funnel was made. Radial incisions were made using scissors. Fibrovascular tissue was dissected from the ciliary processes all round, then onwards along the plateau of retina and into the funnel. Membranes were dissected from the retinal surface to the extent possible.
The retina was noted to go posterior with each step and as the dissection progressed. Eventually, the case was closed under air after it was deemed that no further dissection can be done to prevent any iatrogenic complications.

Points for discussion:
1. Could we have dissected further?
2. Ideal time for repeat intervention, if any is deemed necessary!