Surgical steps - Primary pars plana vitrectomy for rhegmatogenous retinal detachment

In this video we discuss the surgical steps in primary PPV for Rhegmatogenous retinal detachment At first, a 23-gauge trocar is placed inferotemporal in a beveled uniplanar incision to insert the infusion line. Then, ensure the infusion line is fluid-filled, interrupt the flux and after connecting the infusion and check the correct position the infusion can be turned on. A second trocar is placed to connect a Chandelier light. In cases of hypotony or thicker sclera, a biplanar incision can be prefered. To place the remaining trocars, you can use bimanual technique, so you hold the globe with a hand while making the contralateral incision. A wide field non-contact view system was placed, and the focus adjusted to start the vitrectomy. In the beginning of the surgery, before core vitrectomy, don’t forget to remove the anterior vitreous behind the IOL and near the trocars. In this case, the preoperative US scans showed a total PVD but, even so, Triamcinolone was used in the surgery to ensure that areas