Hemorrhage of major branch retinal artery during vitrectomy

A 45-year-old man had vitreoretinal surgery for intraocular foreign body. Five weeks postoperatively he developed severe proliferation of fibrous tissue from a chorioretinal scar at the site where the intraocular foreign body had lacerated the inferior temporal retinal artery. During a second vitreous surgical procedure, there was severe hemorrhaging from the previously lacerated inferior temporal retinal artery. Elevation of the intraocular pressure to 80 mm Hg after complete air fluid exchange, followed by repeated application of diathermy, resulted in permanent closure of the inferior temporal retinal artery. Elevation of intraocular pressure above the systolic blood pressure of the retinal artery following air fluid exchange offers a successful method for dealing with this serious complication of vitreoretinal surgery.