I do ERM-ILM peeling by using: Chandelier illumination, aspheric macular contact lens, 23 G needle OR closed tip ILM Forceps for creating the ILM flap, clamping the infusion cannula during the BBG stain injection. Chandelier allows for satisfactory illumination with a free second hand that stabilizes the working hand and thus provides stability, precision, control and dexterity. However, positioning and redirecting by the assistant may be essential. 23 G needle is non-bent, allows for creating the ILM flap without pinching the retina even though it is sharp. Aspheric lens gives a very good resolution. Clamped infusion cannula during BBG stain injection allows gravitation of BBG on macula, and more effective staining…. however this may result in transient hypotony.

Cases:

Tractional diabetic diffuse macular edema due to: Epimacular membranes; taut posterior hyaloid; and vitreomacular Traction Fibrovascular proliferations. Results: Complete wide ILM Peeling. Reduction in central macular thickness. Improvement of vision.