Iatrogenic Macular Tear Formation During PVD Induction in a Patient with Diabetic Retinopathy: A Case Report

Abstract Background Epiretinal membrane (ERM) is a common vitreoretinal interface disorder for which pars plana vitrectomy (PPV) is the standard surgical treatment. Induction of posterior vitreous detachment (PVD) is a fundamental step during PPV to relieve vitreoretinal traction. However, PVD induction carries a significant risk of iatrogenic retinal breaks, potetienlly resulting in severe visual impairment. Case presentation We report a case of an intraoperative macular tear that occurred during PVD induction in a patient with an epiretinal membrane and proliferative diabetic retinopathy. The tear was presumed to atrributed to abnormal vitreoretinal adhesion. The complication was successfully managed using an inverted internal limiting membrane (ILM) flap technique, combined with autologous blood and gas tamponade. Postoperatively, anatomical closure of the macular tear was achieved, and best-corrected visual acuity improved to 20/80. Conclusion This case underscores the necessity for caution during PVD induction, especially in eyes with complex vitreoretinal interface pathologies. Furthermore, it provides a practical approach for this uncommon complication.