25-gauge Vitrectomy for Macular Hole Demonstrating ILM Peeling using Triesence Enhancement

Seenu M. Hariprasad, MD, and Daniel Kiernan, MD, perform a 25-gauge vitrectomy for a macular hole. Triesence (Alcon, Fort Worth, TX) crystals coat the macula which helps guide peeling of the internal limiting membrane around the macular hole.

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Comments (12)

Hi EyeBugr: Experience is the answer. Cortical vitreous is 'stringy' and not a distinct membrane, ERM is 'thick' and a distinct membrane, ILM is thin and friable. Really, you need to keep using Triesence or Kenalog to see the difference. When in doubt, it is very easy to reapply and see if anything highlights.

Hariprasad (32 months ago)

how does one know that ILM is peeled and not ERM/hyaloid?

EyeBugr (32 months ago)

Thank you

Belfair MD (36 months ago)

Hi Karun: The 1123x forceps are custom made Synergetics 25g forceps.

Hariprasad (42 months ago)

Hi seenu

karun (42 months ago)

Hi Len: Thanks for the comment.... See my response to Piskulich.

Hariprasad (44 months ago)

difference between triamcinolone and triessence? About $100 :)

feinerl (44 months ago)

whats the forceps you have used ?

Dr B Khare (45 months ago)

Hi Piskulich:

Hariprasad (45 months ago)

whats the difference between triecense and triamcinolone?

piskulich (45 months ago)