Removal of subretinal strands without creating an intentional retinal hole: A case report

Proliferative vitreoretinopathy (PVR) is a severe vitreoretinal disease. In cases of PVR with subretinal strands (SRS), creating an intentional retinal hole is typically necessary for removing SRS during vitrectomy. Herein, we describe a novel surgical approach for managing total retinal detachment (RD) with SRS.

A 59-year-old man presented with vision loss in the right eye persisting for four years before the initial presentation. Visual acuity was limited to light perception. The right eye had a mature cataract, and ultrasound computed tomography indicated total retinal detachment. Consequently, combined cataract surgery and vitrectomy were performed on the right eye. After cataract surgery, vitrectomy was performed using a 27-gauge, four-port system. SRS were identified in all quadrants. A fifth port was created approximately 12 mm from the corneal limbus, facilitating the removal of SRS without an intentional retinal hole. Almost all the SRS were successfully removed through this port using vitreous forceps. Postoperatively, the fundus remained stable without complications such as choroidal hemorrhage. No retinal re-detachment was observed during 13 months of follow-up.

The subretinal port provided an effective means of removing SRS without creating an intentional retinal hole in this case of total RD with SRS. This technique could be applicable to similar cases of total RD.