Modified technique for inducing posterior vitreous detachment through the posterior precortical vitreous pocket during microincision vitreous surgery with a wide-angle viewing system.

ABSTRACT

PURPOSE: To introduce a simple technique to create a posterior vitreous detachment (PVD) through the posterior precortical vitreous pocket (PPVP) during microincision vitreous surgery using a wide-angle viewing system (WAVS). METHODS: This study included 20 eyes of 20 consecutive patients (mean age, 65.6 years; range, 56-76) with a stage 2 or 3 idiopathic macular hole who underwent 25-gauge microincision vitreous surgery using a WAVS and phacoemulsification surgery. A triamcinolone suspension was injected into the vitreous cavity. The triamcinolone facilitated visualization of the posterior wall of the PPVP. Using a vitreous cutter, we suctioned the outer margin of the PPVP. After a resultant small break of the posterior hyaloid membrane developed and enlarged rapidly, a PVD easily expanded at the periphery. RESULTS: Using this technique, we induced a PVD without close proximity to the optic disk and macula. CONCLUSION: This technique is an easy and safe method for creating a PVD during microincision vitreous surgery using a WAVS.