First Author: L.Sararols Ramsay SPAIN
Co Author(s): K. Baton G. Londono M. Castilla M. Guarro
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In a high percentage of our vitreoretinal surgeries we need to perform dissection of the posterior hyaloid and it is not always an easy and straight forward technique. Multiple dyes have been used to enhance visualization of the vitreous cortex and indirectly of the posterior hyaloid. We present a new surgical technique that allows us to easily visualize the posterior hyaloid, differentiating when it is adhered to the posterior pole or not adhered, using the same blue dye we would use for epiretinal macular membrane (ERM) dissection or Internal Limiting Membrane (ILM) dissection.
23 G pars plana vitrectomy and phaco-vitrectomy procedures, no new material is needed.
Our technique does not add any step or burden to our regular surgery, we shall just use the same dye we use for the visualization of ERM or ILM, but we inject it over the posterior pole just after we have performed core vitrectomy. The dye will adopt the shape of “Blue Lagoon” if hyaloid is not adhered and “Blue Bulks” if it is adhered to the posterior pole. With the vitrector tip we can aspirate and “grasp” the posterior stained hyaloid and easily see how the blue dye moves and cleaves between the layers.
Our technique allows an excellent visualization of the posterior vitreous and hyaloid and this way the dissection can be performed in a much more secure way, preventing iatrogenia and complications and facilitating the surgeon to detect areas with pathologic adhesions and confirming that all the posterior hyaloid is free. After it’s dissection the blue will have stained also the ERM or ILM and it can be dissected in the manner and lens you are familiar with.
Using the blue stain immediately after the central vitrectomy allows a perfect visualization of the situation of the posterior hyaloid and it’s dissection can be performed in an easy and secure way. After it’s dissection the blue will have stained also the epiretinal membrane or the internal limiting membrane, so usually no more dye has to be added.