Use of a Backflush Needle with a Silicone Tip Cannula to Embed Lamellar Hole-associated Epiretinal Proliferation.

PURPOSE: For the treatment of lamellar macular hole (LMH), the recent development of a lamellar hole-associated epiretinal proliferation (LHEP) embedding technique is likely to improve functional and anatomical results. However, the peeling of LHEP is often technically challenging. We have developed a new technique using a backflush needle with a silicone tip cannula that seems safer and more effective for use in LHEP embedding.

METHODS: A 25-gauge vitrectomy system with an enhancing visual acuity (EVA) system (D.O.R.C., Zuidland, Netherlands) was used in all cases. After core vitrectomy, triamcinolone acetonide (Wakamoto Pharmaceutical Co., Ltd., Tokyo, Japan) was used to visualize the membrane. A 25-gauge backflush needle with a silicone tip cannula was used to remove the thin preretinal membrane centripetally, leaving an LHEP on the edge of the hole. Brilliant blue G (ILM Blue®; D.O.R.C.) was then used to stain the ILM.

RESULTS: This technique was used in 6 eyes with LMH. In all cases, peeling and embedding of the LHEP was effectively performed without damaging the ILM or causing retinal hemorrhage. No other intra- or postoperative complications were experienced.

CONCLUSION: Using a silicone-tipped backflush needle with passive aspiration was a simple and effective technique for peeling and embedding of LHEPs in this small series.