Simple maneuver for unfolding giant retinal tear inverted flap trapped under perfluorocarbon bubble

Inverted retinal detachments secondary to giant retinal tears are sometimes difficult to unfold with the perfluorocarbon (PFC) bubble even after complete epiretinal dissection due to the tendency of the flap to maintain its inverted configuration. The following maneuver has been performed in two cases. After reducing the PFC bubble volume to the level of the border of the flap, the tip of the same perfluorocarbon injection cannula is used to capture the inverted retinal flap with gentle suction. The flap is lifted and brought centripetally to "cover" the PFC bubble and then released by stopping suction. Then bubble volume can be increased to reapply the entire retina, allowing for continuation of surgery. This simple maneuver allows, in one quick surgical step and without the introduction of new instruments, unfolding of persistently inverted giant retinal tears.