Lord of the Ring-Tackling Table Top TRD

A young diabetic patient presented with non resolving vitreous hemorrhage. Intraoperatively after removal of hemorrhage, he was noted to have thick ring shaped fibrovascular proliferation over posterior pole and table top TRD. This is one of the most challenging scenarios faced by a VR surgeon. Option of bimanual vs unimanual surgery were analyzed. We decided to proceed with latter. The dissection was started on temporal side of ring shaped fibrovascular proliferation from inside out fashion. Nasal part of FVP was dissected in outside in fashion. ILM peeling was done with ILM peeling forceps. Unimanual technique of membrane dissection is helpful in such cases with help of modern small gauge vitrectomy cutters.

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