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Methods:

Preoperative Avastin 24 hours Always Bimanual approach For dissection I use: a 23G vitreous cutter, Scissors, Fashioned 23G Pick. I use the lower temporal trocar sometimes- in cases with dense fibrovascular proliferations in the upper retina. the working trocars in these cases are the lower temporal and upper nasal The membrane holding is with forceps via the upper nasal trocar, while the membrane dissection is with a cutter/ scissor/ pick via the lower temporal trocar.

Advantages:

Proper membranes dissection, Minimal bleeding and Minimal iatrogenic retinal breaks.