Iatrogenic macular break during vitrectomy for proliferative diabetic retinopathy

Background: We report 1 case of iatrogenic macular break during vitrectomy for proliferative diabetic retinopathy. Case Report: We performed vitrectomy on a 64-year-old male with progressive diabetic macular tractional retinal detachment. The surgical procedures performed included primary vitrectomy and membrane dissection using vitreous scissors. After dissection of fibrovascular membranes, we removed the clot on the macula. However, an iatrogenic macular break occurred due to strong adhesion between the clot and the fovea. We removed the membrane with the clot using vitreous scissors and examined the residual vitreous cortex in the macular area. After vitrectomy, the macular break enlarged to a round hole. Conclusion: To prevent this type of intraoperative complication, it is necessary to remove the vitreous cortex completely and to avoid applying strong tractional force to the macular area where bleeding had occurred.