U-Turn Technique for Fovea-Sparing ILM Peeling

In this surgical video, Dr. Rameez Hussain presents the U-turn technique for fovea-sparing internal limiting membrane (ILM) peeling. Used for vitrectomy surgeries in which the fovea is anatomically compromised, this easy method may be helpful in cases of diabetic macular edema (DME) and vitreomacular traction syndrome. In this case, the patient had a fall and experienced fluctuations in blood pressure after intravenous sedation. Dr. Hussain used a Stellaris machine that had no IOP compensation feature. He lowered and adjusted the intraoperative IOP and managed it by infusion bottle height, which may not always be accurate. The patient did not receive any postoperative injections. Because the postoperative course takes 3 to 6 months for reduction in macular thickness and restoration of its contour, any additional injections would be administered after functional and anatomic success can be gauged.

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