Another week, another proliferative diabetic retinopathy tractional retinal detachment (PDR TRD).
We had 2 nasty ones this week but here’s a recent patient with an updated postoperative photo at 6months post-op. Preoperative photo shows a large posterior tractional detachment with overlying vitreous haemorrhage in their left eye. This patient actually presented due to sudden loss of vision in their right eye due to a less severe vitreous haemorrhage. The patient underwent vitrectomy and panretinal photocoagulation in the left eye. This patient did well with their vision improving from Hand Motions to 6/9 (20/30) at 6months follow up (3rd photo).
Tractional detachments are some of our most difficult operations and require implementation of several different techniques and instruments. In the accompanying video, the use of a chandelier light source is implemented to allow delicate bimanual (two-handed) dissection of the fibrovascular membranes off the retina. Some of these surgeries can last several hours and are definitely best left to well-trained and proficient surgeons. These patients are often young so a good result is important to ensure a lifetime of functional vision.
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