case_images: PMC10903711_01
case_images: Fundus photo of the left eye showed a sealed perforation site
case_images: MEAJO-30-59-g001.jpg
case_images: PMC10903711_01_MEAJO-30-59-g001.jpg
case_images: meajo_71_23-f001
case_images: In the operating room (OR), a 23-gauge PPV was started, three-port sclerotomies were performed with complete vitrectomy, perfluorocarbon liquid was injected to reattach the retina, fluid-air exchange was done and all the subretinal fluid was aspirated till the retina flattened completely then endolaser was applied to seal the breaks, following that, 1000 cSt of SO was injected while adjusting the infusion pressure gradually from 20 mmHg till zero, at near fill, SO was observed leaking through a superiotemporal hole in the globe at or anterior to the equator without bleeding, the original surgery was aborted, a 180  temporal peritomy was done between 12 and 6 o'clock followed by isolation of superior and lateral recti that revealed a circumferential 7 mm long globe wound extending from the temporal edge of superior rectus to the lateral rectus 9-10 mm from the limbus which was repaired by 6 interrupted 0.7 Vicryl sutures and surgery was completed as planned [Figure 1], sclerotomies sutured and postoperative medications were applied, He was sent to recovery in good conditions and discharged on the 5th postoperative day following an unremarkable course.
case_images: PMC10903711_02
case_images: B-scan of the left eye shows dens vitreal opacities with posterior vitreous detachment (PVD), Retinal Detachment (RD) detected superior temporal to inferior from almost posterior equator to almost equator except inferior only posterior RD, images of the retina break detected inferior temporal posterior equator. Mild sub-retinal opacities. No scleral laceration or other finding detected
case_images: MEAJO-30-59-g002.jpg
case_images: PMC10903711_02_MEAJO-30-59-g002.jpg
case_images: meajo_71_23-f002
case_images: Preoperatively, local anesthesia was done in the form of peribulbar injection inferiotemporal, upon checking for globe akinesia before draping, a dark superionasal conjunctival chemosis, a dragged iris toward the conjunctival chemosis and an anterior chamber hyphema were noticed, a soft globe was felt, indirect ophthalmoscopy showed vitreous hemorrhage, IOP was 9 mmHg by I care, both B-scan [Figure 2] and ultrasound biomicroscope examination were performed and did not show a clear area of perforation, surgery was aborted.