Challenges:
1) Absolutely one eyed patient
2) Optic pit patients are know to have very sticky vitreous and one of the most difficult for PVD induction
3) Optic pits communicate with CSF. Silicone oil is contraindicated. Lady has 1 year old twins. Putting gas will temporarily blind her for 3-4 weeks
4) High chances of recurrent detachments due to proliferative vitreoretinopathy.
Procedure done for retinal detachment:
1) Sutureless #mivs at Mumbai Eye Retina Clinic was done with triamcinolone assisted PVD induction.
2) Encirclage was pre placed to reduce chances of recc RD
3) ILM staining with BBG dye. Limited ILM peel over papillo macular bundle was done.
4) Stuff the pit: ILM hinged at ONH and then packed into the optic pit in layers
5) Temporal drainage retinotomy, FGE and SRF drainage.
6) Pit lasered
7) Low percentage gas injection so that its absorbs faster.
Outcome:
- Vision improved to 6/18!!
- Retina attached, No PVR
- Lasered pit seen with resolution of schisis
