Simple new technique for macular pucker peel without forceps.

Area of Science:

• Ophthalmology
• Retinal Surgery
• Surgical Techniques

Background:

• Macular pucker (MP) is an epiretinal membrane that can cause visual distortion.
• Traditional surgical peeling of MP often requires specialized microforceps.
• Developing simpler, effective surgical methods is crucial for retinal surgery.

Purpose of the Study:

• To evaluate the effectiveness of a novel macular pucker peel technique.
• To assess anatomical and functional outcomes of using a 25-gauge pars plana vitrectomy (PPV) cutter without forceps for MP surgery.
• To determine the safety and simplicity of this alternative surgical approach.

Main Methods:

• A prospective case series of 14 eyes with MP underwent 25-gauge pars plana vitrectomy (PPV).
• A new peeling technique was employed, engaging the membrane edge with the vitrectomy cutter's vacuum.
• Membrane peeling was completed by maintaining vacuum or regrasping, avoiding microforceps.

Main Results:

• Macular pucker peel was successful in all 14 cases without requiring microforceps.
• Best corrected visual acuity improved significantly from 0.6 to 0.23 logMAR (P < 0.001).
• Mean central retinal thickness decreased significantly from 489.7 to 377.6 μm (P < 0.001).
• No intraoperative or postoperative complications were reported during the follow-up period.

Conclusions:

• Macular pucker peel using a 25-gauge vitrectomy probe without forceps is a viable, safe, and simple surgical alternative.
• This technique eliminates the need for additional instrumentation like microforceps.
• The method consistently yields positive anatomical and functional results in patients with macular pucker.