Intravitreal removal of large, fibrotic choroidal neovascular membrane complexes in submacular surgery

Submacular surgery is a current alternative technique for the treatment of subfoveal choroidal neovascular membranes (CNVM). One of the difficulties often encountered with this technique is the actual removal of the neovascular membrane complex from the eye. It is often too large and fibrotic to be removed directly through a sclerotomy site without risking significant sclerotomy site complications. The vitreous cutter can be used, but despite high aspiration settings, the large, fibrotic neovascular membrane complex may still not be able to be completely removed safely and expeditiously. We describe an alternative technique using the phacofragmentation handpiece to remove large fibrotic neovascular membranes from the vitreous cavity thereby reducing sclerotomy site complications and surgical time.