Case 1 A 57-year-old gentleman underwent combined phacoemulsification with intraocular lens implantation and vitrectomy for idiopathic full thickness macular hole (FTMH). After 25G core vitrectomy, posterior vitreous detachment (PVD) was induced by suction from vitreous cutter and extended till the vitreous base. Intraocular pressure (IOP) was maintained at 30 mmHg with aspiration rate of 400–450 mmHg. Brilliant blue G (BBG) 0.05% dye (Ocublue Plus; Aurolab, Madurai, India) was used to stain the internal limiting membrane (ILM) in air-filled eye for 1 minute. Infusion fluid was restarted to exchange air with fluid to proceed for ILM peeling. A radial full thickness retinal break developed at the mid-peripheral retina in the supero-nasal quadrant (SNQ) along the jet of fluid from infusion cannula during the process of air–fluid exchange. Internal limiting membrane (ILM) peeling was performed around the macular hole with inverted flap technique and laser photocoagulation performed around the peripheral retinal break. Fourteen percentage C3F8 gas tamponade was used. Six weeks after surgery, macular hole was closed (type 2) and retina remained attached to the last follow-up, 3 months following surgery (Fig. 1).
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