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Epiretinal membrane after ocular trauma

This is a video shared by Dr. Nassim Abreu from Santo Domingo – Dominican Republic

This is a 24-year-old male patient with history of a penetrant ocular trauma in his left eye, with a knife, 2 months ago. In the primary surgery lens was aspirated and corneal e scleral sutures were made to stabilize the globe. After 2 months patient was submitted to the second procedure to remove a fibrotic tissue from the macular region.
So, pars plana vitrectomy was made and brilliant blue dye was used to peel the dense epiretinal membrane and the internal limiting membrane in block.
In these cases, it’s important to remove carefully the dense fibrotic tissue above fovea to avoid excessive traction and iatrogenic macular hole. For the peeling, you can remove the membranes around the perifoveal zone by using tangential traction.

A Tano scraper or a Finesse Flex loop can be used as adjuvant to the retinal forceps to create flaps, lift the membranes and facilitate the peeling.
In the end of the surgery fluid air exchange was made and once it wasn’t retinal breaks in the periphery, silicone oil or gas injection wasn’t necessary in this case.

Nassim Abreu MD
Santo Domingo – DO
Filipe Lucatto MD
Juliana Prazeres MD
Salvador – BR