Three simple approaches to visualize the transparent vitreous cortex during vitreoretinal surgery

Area of Science:

• Ophthalmology
• Surgical Visualization
• Retinal Surgery

Background:

• Pars plana vitrectomy historically addressed opaque vitreous, but current indications involve clear vitreous for conditions like retinal detachments.
• Visualization of transparent vitreous gel is crucial for effective vitreous removal in modern vitreoretinal surgery.

Purpose of the Study:

• To describe methods for enhancing visualization of clear vitreous and epiretinal membranes during vitrectomy.
• To evaluate the efficacy of intraoperative and preoperative agents in improving surgical field clarity.

Main Methods:

• Intraoperative application of autologous blood or crystalline triamcinolone acetonide to stain vitreous structures.
• Intravenous administration of fluorescein for preoperative diagnostic angiography in specific ocular conditions.

Main Results:

• Autologous blood and triamcinolone crystals facilitate visualization of vitreous cortex and epiretinal membranes.
• Fluorescein accumulation in the vitreous cavity, observed during angiography, aids in identifying clear vitreous structures.
• These methods enable better visualization for controlled and complete vitreous removal.

Conclusions:

• Intraoperative autologous blood or triamcinolone enables safe and complete removal of clear vitreous and transparent membranes.
• Preoperative systemic fluorescein significantly improves visualization of previously indistinct ocular structures.