VT127 – Plugging All Loopholes: Surgically Managing Optic Nerve Head Colobomas With Retinal Detachment

Dr.Unnikrishnan Nair R, Dr.Manoj S

This video demonstrates a modification in the surgical management of retinal detachments associated with optic nerve head colobomas. 4 weeks after primary vitrectomy with silicone oil tamponade the patient presented with a large nasal retinal re-detachment. On re-surgery, intra-operatively it was noted that the detachment was due to sub-retinal oil and the likely point of seepage was the defect in the coloboma edge. A large retinectomy was done to remove the sub-retinal oil. After fluid air exchange , fibrin glue was dropped into the coloboma in an attempt to achieve temporary closure of the defect while the retina reattached. The fibrin glue absorbed in two weeks as demonstrated by OCT. The retina remains attached after one year follow-up. Fresh Sub-retinal oil migration was prevented. Intra-operative use of fibrin glue over the disc coloboma assists in the temporary sealing and separation of the fluid and oil from entering the tissue defect in the crucial post operative period.

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