A 65-year-old female presented with shadow like feeling in OD for 1 week. She had macular hole(MH)surgery in OU 10 years back elsewhere. At presentation she had type 2 closure of holes with BCVA 5/60 in OU. OD had inferior retinal detachment(RD) beyond arcades and choroidal detachment(CD). She was started on oral steroids and advised early surgery. Patient reported after one week with vision of finger counting and macula off RD and inferior CD. During vitrectomy the infusion canula was visualised and started CDs increased and canula was noted under pars plana. So we changed canula site and DRAINED CD. Followed by Vitrectomy completion. MH was large so we planned an autograft. Hole was SEALED with graft under PFCL. Fluid DRAINED through retinotomy and laser done to breaks to SEAL them and FGE done. Followed by silicone oil. Postopertively the graft was stable with attached retina and visual recovery to 6/60. So the triple trilogy of RD,CD and MH was managed in the challenging surgery.
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