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With current style of endoillumination, visualisation of the posterior vitreous and retina is adequately achieved. However, accessing pre-equatorial structures remains a problem, as even wide-field optics and forced rotation of the globe do not allow visualisation of far periphery. Indenting the sclera becomes mandatory. Available options include relying on an assistant, or the use of accessory light sources with the accompanying additional costs, and sclerotomies. To overcome these challenges, the principle of trans-illumination can be gainfully used. Schmidt et al 1 described the 'diaphanoscopic illuminator', an indentation device which integrates in its tip a fibre optic light cable. Limitations of this instrument comprise poor visibility caused by reduction of transmission by the sclera. More recently, Veckeneer proposed to indent the sclera with the conventional 20-gauge light pipe, and to enhance vitreous visualisation by filling the vitreous cavity with perfluorocarbon liquid (PFCL) and injecting triamcinolone acetonide on top. An additional refinement of this technique is to use a sleeve on the light probe, like the 'lightindentor' produced by DORC (Zuidland, The Netherlands). Such a sleeve reduces abrasion of conjunctiva and sclera and increases the rigidity of the light pipe. The authors recommend this technique in all cases for which trimming of the vitreous base is considered important. 2
I perform thorough vitreous base shaving in all my vitrectomy cases and, although I find the technique proposed by Veckeneer useful for retinal detachments, routine use of PFCL is expensive and usually not necessary for elective procedures.
The purpose of this paper is to describe an alternative technique of vitreous base visualisation by means of...