With this patient microscopic control was not possible due to a small fixed pupil with vascularized synechiae to a posterior chamber IOL. There was recurrent intraocular bleeding and elevated IOP. The ciliary body ablation was accomplished first with a 532 laser fed through the working channel of the endoscope. Examination of the peripheral retina revealed a ring-like rhegmatogenous retinal separation and a large inferior tear with persistent traction. Endoscopically controlled imaging and a second instrument (suction/cutter) removed the tractional elements and permitted an air fluid exchange. Retinal reattachment occurred as the air-fluid exchange was completed permitting laser ablation of the ring like area that had been separated. The entire procedure was performed utilizing the small gauge endoscope.

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