Dr. PURVA VALVEKAR

, Dr. VIKRAM MEHTA

Abstract

A 57Yr male, smoker presented with metamorphosia in LE since last 4 months. Medical history was not significant. VA was 6/36. Anterior segment examination was WNL with clear lens in situ. IOP was 14mm/Hg. Retina examination showed full thickness macular hole with retina on. Other eye examination was WNL. After informed written consent he was posted for 23G PPV+ BB assisted ILM peeling+ C3F8 under local anesthesia.At starting of surgery mild EOM moments with poor block was noted. Initial steps of PPV were completed when pt became uncooperative & noticeable eye movements made ILM peeling difficult and time consuming. Even after counseling, he was getting apprehensive during last few steps of surgery.At last surgery went uneventful with completion of all the steps.

Take home message- Even if a single step is remaining, one must swallow his pride, step back & give augmentation anesthesia without hesitation.This bodes well not only for patient’s outcome but also for surgeon’s stress levels.