Iatrogenic Pars Plana Tear Causing Retinal Detachment Case Report
Refka, Mohammed Nabeel, Alzubair Sambas, Mohammed Mutli T. Almutairi.
Abstract
Background: Pars plana vitrectomy (PPV) is a common surgical procedure used to treat various retinal conditions, but it can lead to complications such as retinal detachment or iatrogenic retinal tears. This case report describes a rare instance of a pars plana tear caused iatrogenically during PPV.
Case Presentation: A 60-year-old male underwent PPV for diabetic traction membrane non clearing vitreous hemorrhage and epiretinal membrane removal. During the procedure, after insertion of 3 23-gauge trocars, a probe was inserted superotemporal but the instrument was not visible through the pupil. It was initially thought to be under the iris. The trocar was then skewed downward in an attempt to visualize it, but the instrument inadvertently hit the pars plana nasally, causing an iatrogenic tear. This tear separated pars plana, leading to peripheral retinal detachment due to subretinal fluid accumulation. The senior surgeon took over, Completing the case then sealing the tear with laser photocoagulation applied to the peripheral retina, effectively securing the break. One month following the surgery, visual acuity improved from 20/40 to 20/28.
Conclusion: Iatrogenic pars plana tears are a rare but significant complication of PPV. This case highlights the importance of meticulous surgical technique and demonstrates that laser photocoagulation is a viable treatment option for securing such tears.
Key words: Iatrogenic Pars Plana,Tear, Retinal Detachment.
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