July 31, 2025
3 min watch
Key takeaways:
- During silicone oil exchange, make sure the cannula is inserted properly.
- Preserved sclera with gas tamponade may help manage optic pit maculopathy.
LONG BEACH, Calif. — In this Healio Video Perspective from the American Society of Retina Specialists annual meeting, Sunir J. Garg, MD, FACS, FASRS, presented lessons learned from two complex surgical cases.
In the first case, a patient with uveitis who developed proliferative vitreoretinopathy experienced complications during silicone oil exchange.
“Everything seemed to be going fine, and then all of a sudden, the eye started to become very firm, and the red reflex changed,” Garg told Healio. “What we found on further inspection is that we actually ended up infusing a fair bit of oil in the suprachoroidal space.”
Garg noted that the cannula may not be inserted properly in patients with “boggy” choroids and that the surgeon should make sure that the oil flows properly into the eye.
“If suprachoroidal oil happens, you can drain it like you would hemorrhage a choroidal detachment,” he said.
The second case involved a patient with optic pit maculopathy. After complications with internal limiting membrane (ILM) flap surgery following induced posterior vitreous detachment, Garg used a piece of preserved sclera and additional laser as a solution.
“There wasn’t much residual ILM, but I made a new flap to cover it, put in a gas tamponade, and 4 years later, that technique, at least in this person, has been working really well,” he said.
Sources/Disclosures
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Rezaei K, et al. Retinaws. Presented at: American Society of Retina Specialists annual meeting; July 30-Aug. 2, 2025; Long Beach, California.
Disclosures:
Garg reports no relevant financial disclosures.
