CNV Adherent to Macula

Especially in long standing CNV, like occult CNV, fibrotic PED the RPE-Choroid complex is eventually tightly adherent to the outer retina. In this older film an angulated subretinal forceps is being used as a spatula as well in order to sever off the CNV from the outer retina. Apparently here the connation is too strong. Thus during the subsequent pulling a macular hole is created.  The strong adhesion is apparent from the indentation (navel) of the macula. I cannot exclude that a RAP-formation was unrecognized here. The procedure is being completed by a RPE-Choroid free transplant. Since a macular hole developed one should have better peeled the ILM at the completion.