Vitrectomy for retinal detachment with a superior break. 25 gauge MIVS vitrectomy is carried out. The break is noted superiorly. Hyaloid is attached and triamcinolone is used to stain the vitreous. Once the planes of the hyaloid and underlying mobile retina are clearly visible we start to engage the vacuum of the cutter within the hyaloidal tissue. Gradually and patiently the scaffold of attached hyaloid is almost peeled of using vacuum carefully so as not to create a iatrogenic break in the mobile retina. Once the hyaloid comes off it becomes easy to clear the residual vitreous. After that air fluid exchange is carried out followed by endodrainage from the existing break. Once the retina is well flattened, endolaser is done around the break and gas is used as a post operative tamponade | Dr Manish Nagpal | Retina Foundation | www.retinafoundation.com
