Separation of Posterior Hyaloid with Retinal Pick

In this video, Drs. Riley Sanders and Ahmed Sallam demonstrate induction of posterior vitreous detachment using a retinal pick or bent 25-gauge needle. This technique is performed during vitrectomy surgery in eyes with a firmly adherent hyaloid. Histologic and OCT analyses have shown the posterior hyaloid to be a multilayered, laminate structure. The pick method can be effective in cases where the surgeon fails to induce posterior hyaloid separation with active suction using the vitreous cutter or a soft tip extrusion. Sharp dissection can create a clean dissection plane beneath the outermost layer of the posterior hyaloid. The surgeons demonstrate this technique in an 81-year-old patient who was indicated for surgery due to traumatic posterior dislocation of the intraocular lens.