DR. NIKITA GUPTA

, DR. ATUL ARORA, DR. VISHALI GUPTA

Abstract

A 14-year old girl presented with vitreous haemorrhage(VH) in her left eye secondary to Acute Myeloid Leukemia. 25G pars plana ports were made. After core vitrectomy and clearing of VH, a large macular hole>1000microns was observed intraoperatively. Following triamcinolone assisted posterior hyaloid removal, a thin taut residual transparent sheet was noted over the macula, difficult to lift from the retinal surface. Brilliant Blue Green staining confirmed it to be Internal Limiting Membrane. Microscope integrated OCT showed the ILM to be detached at the macula with sub-ILM altered blood. ILM was subsequently peeled and the free flaps were stuffed in the hole. PFCL was injected over the stuffed ILM flap and the position of the flap in the hole was confirmed on mi-OCT. Fluid air exchange was done gently followed by 14% C3F8 gas tamponade. Post operatively there was anatomical closure of the macular hole. Long standing sub ILM bleed resulted in formation of macular hole in our case.