Triamcinolone acetonide-assisted peeling of the internal limiting membrane

We report on a new technique to peel the internal limiting membrane (ILM) using triamcinolone acetonide (TA) to facilitate visualization during surgery.

Interventional case series.

In four eyes of four patients with macular hole, TA was used during vitrectomy to visualize the hyaloid. After the posterior hyaloid was surgically separated from the optic nerve head and posterior retina, TA suspension was injected over the posterior pole. Intraocular forceps was used to peel the ILM in a circumferential manner around the macular hole.

Numerous particles of TA were dispersed over the posterior retina as white specks. Once the ILM was peeled, the peeled area was clearly visualized as an area lacking the white specks. In all patients, the macular holes closed. No adverse reactions were observed during the 3-month follow-up period.

TA-assisted ILM peeling is an effective and safe technique for macular hole surgery.