Scleral rupture during 23-gauge pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment, without known predisposing factors, is a rare but catastrophic complication. Scleral rupture in our patient developed in superotemporal quadrant corresponding to the area of chorioretinal atrophy in retina. Prompt suturing of scleral rupture, usage of perfluoro-N-octane (PFO) as short-term endo-tamponade, and removal of epiretinal membrane (ERM) under silicone oil (SO) were the major contributing factors leading to successful outcome. High index of suspicion should be kept for any chorioretinal atrophic patches and sclera corresponding to these areas should be carefully examined for any pathosis.
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