Vitrectomy for Sub-ILM Hemorrhage Secondary to Valsalva

In this surgical video, Dr. R. Rishi Gupta and colleagues manage a patient referred for a Valsalva-induced sub-inner limiting membrane (ILM) hemorrhage. They used triesence to confirm hyaloid separation. After vitrectomy, the ILM was stained with indocyanine green and removed using a pinch-and-peel technique to evacuate the hemorrhage; dehemoglobinized blood was observed on the undersurface of the ILM. A backflush needle was used to aspirate and remove the residual red blood cells on the underside of the ILM. By postoperative day 1, the patient’s vision had improved from count fingers to 20/25.

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