At the end of an uncomplicated pars plana vitrectomy with wide-angle viewing, the surgeon performs a careful peripheral examination under low infusion pressure. Where is the most common location of iatrogenic retinal breaks created during vitrectomy?

• A At or adjacent to the sclerotomy sites ✓
• B At the optic disc margin where the posterior hyaloid inserts
• C Along the temporal vascular arcades during membrane dissection
• D At the ora serrata from infusion cannula trauma

Explanation

Iatrogenic breaks occur most frequently at or near the sclerotomies, produced by vitreous base traction when instruments are withdrawn or inserted, particularly with 20-gauge systems and in phakic eyes. This is why routine examination of the peripheral retina around each port at the end of surgery, with endolaser application to any suspicious area, is standard practice. Breaks at the disc margin or arcades relate to pathological traction, not instrument-induced injury.

Reference: Ryan's Retina, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.