During pars plana vitrectomy for a complex case, the surgeon notices proliferative vitreoretinopathy (PVR) with posterior membranes causing retinal star folds. The most appropriate intraoperative adjunct to relax the retina and allow flattening is:

• A Intravitreal triamcinolone injection
• B Scleral buckle placement without vitrectomy
• C Relaxing retinotomy or retinectomy ✓
• D Intravitreal bevacizumab injection

Explanation

In PVR with posterior membranes causing retinal star folds that cannot be adequately relieved by membrane peeling alone, a relaxing retinotomy (or retinectomy if extensive) is performed. This involves cutting the retina to release circumferential traction and allow the remaining retina to flatten against the RPE. PFCL is then used to unfold and stabilize the retina before laser and silicone oil tamponade. Triamcinolone aids visualization of membranes but does not mechanically release traction. Scleral buckle alone cannot manage PVR-related posterior traction.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.