Macular fold after PPV for RD

A 53-year-old man with a macula-off RD underwent left eye pars plana vitrectomy with air-fluid exchange, laser retinopexy, and injection of 14% SF6 gas. There were 4 retinal breaks between 10 o’clock and 12 o’clock including one large tear. He was compliant with facedown positioning. On the 8th post-operative day, a retinal fold along the 4-10 o’clock meridian was seen coursing through his central macula. He underwent repeat PPV but multiple attempts to lift and flatten the retina were unsuccessful.