Recognition and Removal of the Posterior Cortical Vitreous During Vitreoretinal Surgery for Impending Macular Hole

Vitreoretinal surgery for impending macular hole includes recognition and removal of the posterior cortical vitreous. Previously described surgical techniques for removal of cortical vitreous used either rigid instruments (a tapered extrusion needle or a barbed microvitreoretinal blade) or a short fenestrated soft-tipped suction needle. We used a technique with the cannulated extrusion needle that detects the presence of the posterior cortical vitreous and facilitates safe removal of this layer from the retina. Although this technique is most useful when performing vitrectomy for impending macular hole, it may also be used during vitrectomy for other conditions with uncertain detachment of the posterior cortical vitreous.