50 year old male, presented with recurrent RRD, PVR, extensive chorioretinal scars, stiff retina and large irregular macular hole following. He gave history of repeated VR procedures including 2 Vxs, gas then SiO injection and finally SiO removal. During reoperation,
ERM were removed. ILM could be peeled over the posterior pole but there was no ILM around the hole. Because of retinal shortening and extensive peripheral scarring, 360 retinotomy/retinectomy was performed. Free retinal graft was cut from inferior retina, dragged under PFCL to cover the macular hole. Retinal reattachment was achieved using PFCL, endorser was applied for 360 degrees and finally direct PFCL/SiO 2000Cs exchange was performed. The patient was placed in face down position for 5 days.
SiO removal was performed 3 months later. V/A improved from HM to 0.05
OCT done I month after SiO removal revealed attached retina, closure of the MH with retinal graft